Parental anxiety and depression levels associated with challenge tests in children with suspected drug and food allergies

Aim: Oral food challenges (OFCs) and drug provocation tests (DPTs) are currently the gold standards for evaluating food and drug hypersensitivity, respectively; however, use of these tests on children may generate anxiety and depression among their parents. Our aim was to explore depression and anxiety level among parents of children who were undergoing clinical evaluation via a DPT or OFC. Methods: This cross-sectional study included parents of patients diagnosed with food or drug hypersensitivity reactions in the pediatric allergy clinic between September 2018 and October 2019. Children in Group 1 were subjected to DPT, Group 2 underwent OFC, and Group 3 were healthy controls. Before a child underwent an OFC or DPT, all parents (one parent per child) completed the Hospital Anxiety and Depression Scale, which is a serial assessment for symptoms of depression and anxiety. Results: The study included parents of 105 children, among which Group 1 (n=50 children) were subjected to DPT, Group 2 (n =35 children) underwent OFC, and Group 3 (n=20 children) were healthy controls. In all three Groups, parents were primarily female (62.9%). Anxiety and depression scores were significantly higher among the parents of children in Groups 1 and 2 vs. those of children in Group 3 (P=0.002 and P=0.028, respectively). Anxiety scores were significantly higher among parents of children in Group 2 than those of children in Group 1 (P=0.017). Conclusions: DPTs and OFCs have a significant impact on the emotional status of parents. Parents of children with suspected or documented food allergy experience particularly elevated levels of anxiety and depression before an OFC.