RESPIRATORY
AS THE INCIDENCE OF HAYFEVER CONTINUES TO SOAR, RESEARCH CONTINUES TO SHOW THAT THE SYMPTOMS OF HAYFEVER MAY GO WELL BEYOND SNEEZING AND A RUNNY NOSE.
HAYFEVER:
THE PSYCHOLOGICAL IMPACT A
ccording to the World Health Organization, between ten and 30 per cent of the worldwide population suffer from allergic rhinitis or, as it’s more commonly known, hayfever. It’s estimated that around ten million people in Britain suffer from this condition which, while not necessarily serious, can cause a great deal of discomfort and inconvenience to sufferers.
As a pharmacist, you’ll be well used to hearing your patients complain about the symptoms of their hayfever: from a running nose to an irritating cough; from itchy, sore eyes to a postnasal drip; from fatigue to allergic ‘shiners’ – those swollen blue patches under the eyes.
Besides making them miserable, hayfever can have a detrimental effect on sufferers’ performance at work or school and can generally interfere with their lives. Some of the most common complaints are:
• Reduced quality of life: Hayfever can interfere with a patient’s enjoyment of activities and cause
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them to be less productive. For many people, hayfever symptoms can lead to absences from work or school.
• Poor sleep: Hayfever symptoms can keep patients awake or can make it hard for them to stay asleep. This can ultimately lead to fatigue and a general feeling of being unwell (malaise).
• Worsening asthma: Hayfever can worsen signs and symptoms of asthma, such as coughing and wheezing.
• Sinusitis: Prolonged sinus congestion due to hay fever may increase a patient’s susceptibility to sinusitis - an infection or inflammation of the membrane that lines the sinuses.
As a result of any of the above, allergy sufferers can sometimes say that their symptoms are making them miserable. And they may not be exaggerating! Recent research studies are increasingly indicating that there is an association between allergies such as hayfever and clinical depression.
Various research studies carried out globally have shown that hayfever sufferers may be up to four times more likely to develop severe depression.
In the last year alone, the evidence for an association between hayfever and depression has continued to mount.
A study led by UK researchers from the County Durham and Darlington NHS Foundation Trust found that people with chronic sinus and nasal symptoms had a high rate of psychological distress.
The study, which involved 261 patients who were waiting on endoscopic sinus surgery and focused on patient- reported outcomes, found that younger patients and patients with other medical comorbidities were most likely to report significant symptoms of chronic rhinosinusitis and substantial associated pain and depression.
Put simply, the researchers found that the greater the severity of the physical symptoms, the greater the psychological burden.
Their findings were backed up by
another study last year by Harvard Medical School, which found that about one fifth of patients awaiting minimally invasive surgery for sinusitis also had signs of depression.
In an earlier study in 2016, scientists at the National Yang-Ming University of Taiwan studied nearly 10,000 teenagers with hayfever and 30,000 who didn’t suffer from it. Both groups were monitored for almost a decade and the scientists recorded how many of those who took part went on to be diagnosed with bipolar disorder. Bipolar disorder is characterised by periods of mania, which involve people appearing to be overexcited, agitated and unable to concentrate or sleep. These manic episodes are then followed by a descent into deep depression.
As a result of the study, which appeared in the journal of Psychosomatic Research, the scientists found that the depression was caused by the harmful effect on the brain of inflammation in blood vessels and tissues throughout the body; inflammation caused by an allergic reaction to pollen.
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