Anxiety, stress and risk perception in mothers of food allergic children

• Main Author: Umasunthar, Thisanayagam
• Other Authors: Boyle, Robert ; Hodes, Matthew ; Warner, John
• Published: Imperial College London 2017
• Subjects: 618.92
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.712964

Background: Food allergy is a common chronic condition, affecting up to 10% of infants. Food allergy can occasionally cause anaphylaxis which is sometimes fatal. The risks of fatal or non-fatal anaphylactic reactions in childhood food allergy have not been quantified previously. Anxiety in the mothers of children with food allergy is increased, and it is unclear whether this is associated with misperception of risk of fatal and non-fatal anaphylaxis. Methods: I undertook a systematic review of published data to quantify the risk of fatal and non-fatal anaphylactic reactions to food, in children and adults with food allergy. Secondly a cross sectional survey of mothers of children attending an inner city hospital was carried out, to assess anxiety in the mothers and children, recruited from three groups: those with food allergy, asthma and hospital attendees without chronic illness. Results: The risk of fatal food anaphylaxis was low at one every 100 000 person years for food allergic adults and children. The risk of non-fatal anaphylaxis was higher and varied between 1 every 10 person years for self-reported anaphylaxis and 1 episode every 1000 person years reactions that required hospital admissions. In the cross-sectional survey we assessed 40, 18 and 38 mothers of food allergic, asthmatic, and no chronic illness (controls) children respectively. Mothers of food allergic children showed increased state anxiety and stress than controls. In regression analysis previous anaphylaxis (p=0.008) and poorly controlled asthma (p=0.004) as well as maternal social class were associated with increased maternal anxiety. Child anxiety and adjustment did not differ between food allergic and control groups. Mothers of food allergic children estimated the risk of fatal food anaphylaxis as greater than reality but estimated risk of death from any cause as less than reality. There was no correlation between risk estimation for fatal food anaphylaxis and measures of maternal anxiety/stress Conclusion: The risk of fatal food anaphylactic reactions for food allergic people is very low. In this study mothers of children with food allergy over-estimated this risk and displayed significantly increased anxiety and stress compared with mothers of children with no chronic illness, but risk estimation was not associated with anxiety. The theoretical and clinical implications are discussed.