The Psychological Relieving Effect of Drug Provocation Test in Drug Hypersensitivity

Abstract

Purpose: Drug hypersensitivity is an adverse drug reaction mediated by immunological mechanisms and is accompanied by a significant socioeconomic burden. The drug provocation test (DPT) is the gold standard for drug allergy diagnosis; however, a standardized protocol does not exist. This study aimed to investigate the effects of psychological relief from DPT in patients with drug hypersensitivity. Patients and Methods: A total of 46 patients who had experienced drug hypersensitivity were administered DPT after admission to our clinic at Dong-A University Hospital and asked to complete the questionnaires before and after DPT. Anxiety and depressive symptom levels were assessed using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI)-II, respectively. Results: There was a significant decrease in the BAI and BDI-II scores after DPT than before DPT, respectively (BAI: 10.22 ± 10.75 vs 7.26 ± 6.95, P=0.025; BDI-II: 13.00 ± 7.92 vs 11.17 ± 7.80, P = 0.019). Twenty-two patients with non-anaphylactic drug hypersensitivity showed a significant decrease in the BDI-II scores after DPT (11.50 ± 7.60 vs 9.50 ± 5.98, P = 0.009), but not in the BAI scores (8.45 ± 7.41 vs 6.18 ± 4.58, P = 0.127). However, there were no statistically significant differences in the BDI-II and BAI scores before and after DPT (BAI: 11.83 ± 13.05 vs 8.25 ± 8.56, P = 0.664; BDI-II: 14.38 ± 8.11 vs 12.71 ± 9.01, P = 0.215) in 24 patients with anaphylaxis. Conclusion: DPT may reduce the psychological burden in patients with drug hypersensitivity, especially in those without anaphylaxis.