Background: Hymenoptera venom allergy (HVA) has a prevalence of 3% in adults. Although patients have no ongoing symptoms, they often suffer from an impairment of their psychological well-being and quality of life. Objective: The aim of this study was to analyze sex-specific differences regarding the psychological burden caused by this allergy and handling of the emergency medication. Method: Study participants filled out a questionnaire including sociodemographic and disease-specific characteristics, the Hospital Anxiety and Depression Score (HADS), and theoretical knowledge about the emergency medication set (EMS). Additionally, an objective structured clinical examination was used to assess practical knowledge and handling of the EMS. Results: Fifty-six patients were included (55.4% females). Female patients showed higher subjective anxiety levels due to HVA compared to men (mean 7.2 vs. 4.6, p = 0.0003). Furthermore, the HADS revealed that women had a significant higher anxiety level, especially after Mueller grade I–II anaphylactic reactions (mean 6.3 vs. 2.8, p = 0.0134). This was associated with a higher theoretical but not practical knowledge about their disease. On the other hand, males were less inclined to carry the emergency medication “always” or “almost always” (56 vs. 87.1%, p = 0.0015) but showed higher self-assurance in using it (mean 7.3 vs. 6.1, p = 0.0446). Conclusions: This clinical study provides evidence for sex differences in coping with HVA. The results suggest that females should be monitored more closely for allergy-associated anxiety symptoms, while men need more encouragement to carry the emergency medication.

1.
Przybilla
B
,
Ruëff
F
.
Hymenoptera venom allergy
.
J Dtsch Dermatol Ges
.
2010
;
8
(
2
):
114
30
.
2.
Sturm
GJ
,
Varga
EM
,
Roberts
G
,
Mosbech
H
,
Bilò
MB
,
Akdis
CA
, et al
EAACI guidelines on allergen immunotherapy: hymenoptera venom allergy
.
Allergy
.
2018
;
73
(
4
):
744
64
.
3.
Goldberg
A
,
Confino-Cohen
R
.
Insect sting-inflicted systemic reactions: attitudes of patients with insect venom allergy regarding after-sting behavior and proper administration of epinephrine
.
J Allergy Clin Immunol
.
2000
;
106
(
6
):
1184
9
.
4.
Confino-Cohen
R
,
Melamed
S
,
Goldberg
A
.
Debilitating beliefs, emotional distress and quality of life in patients given immunotherapy for insect sting allergy
.
Clin Exp Allergy
.
1999
;
29
(
12
):
1626
31
.
5.
Cichocka-Jarosz
E
,
Brzyski
P
,
Swiebocka
E
,
Lange
J
,
Tobiasz-Adamczyk
B
,
Lis
G
, et al
Health-related quality of life in polish adolescents with hymenoptera venom allergy treated with venom immunotherapy
.
Arch Med Sci
.
2012
;
8
(
6
):
1076
82
.
6.
Flokstra-de Blok
BM
,
van der Velde
JL
,
Vlieg-Boerstra
BJ
,
Oude Elberink
JN
,
DunnGalvin
A
,
Hourihane
JO
, et al
Health-related quality of life of food allergic patients measured with generic and disease-specific questionnaires
.
Allergy
.
2010
;
65
(
8
):
1031
8
.
7.
Cohen
MB
,
Saunders
SS
,
Wise
SK
,
Nassif
S
,
Platt
MP
.
Pitfalls in the use of epinephrine for anaphylaxis: patient and provider opportunities for improvement
.
Int Forum Allergy Rhinol
.
2017
;
7
(
3
):
276
86
.
8.
Schaarschmidt
ML
,
Gutknecht
M
,
Schoeben
L
,
Schmieder
A
.
Disease burden, psychological well-being and attitudes regarding the set of emergency medication in adults with insect venom allergy
.
Int Arch Allergy Immunol
.
2018
;
176
(
2
):
150
6
.
9.
Webb
LM
,
Lieberman
P
.
Anaphylaxis: a review of 601 cases
.
Ann Allergy Asthma Immunol
.
2006
;
97
(
1
):
39
43
.
10.
Jensen-Jarolim
E
,
Untersmayr
E
.
Gender-medicine aspects in allergology
.
Allergy
.
2008
;
63
(
5
):
610
5
.
11.
Golden
DB
.
New directions in diagnostic evaluation of insect allergy
.
Curr Opin Allergy Clin Immunol
.
2014
;
14
(
4
):
334
9
.
12.
Snaith
RP
,
Zigmond
AS
.
The hospital anxiety and depression scale
.
Br Med J
.
1983
;
292
(
6516
):
344
70
.
13.
Mueller
HL
.
Diagnosis and treatment of insect sensitivity
.
J Asthma Res
.
1966
;
3
(
4
):
331
3
.
14.
Bjelland
I
,
Dahl
AA
,
Haug
TT
,
Neckelmann
D
.
The validity of the Hospital Anxiety and Depression Scale. An updated literature review
.
J Psychosom Res
.
2002
;
52
(
2
):
69
77
.
15.
Gelfand
JM
,
Feldman
SR
,
Stern
RS
,
Thomas
J
,
Rolstad
T
,
Margolis
DJ
.
Determinants of quality of life in patients with psoriasis: a study from the US population
.
J Am Acad Dermatol
.
2004
;
51
(
5
):
704
8
.
16.
Rainville
JR
,
Hodes
GE
.
Inflaming sex differences in mood disorders
.
Neuropsychopharmacology
.
2019
;
44
(
1
):
184
99
.
17.
Bouman
A
,
Heineman
MJ
,
Faas
MM
.
Sex hormones and the immune response in humans
.
Hum Reprod Update
.
2005
;
11
(
4
):
411
23
.
18.
Zuk
M
,
McKean
KA
.
Sex differences in parasite infections: patterns and processes
.
Int J Parasitol
.
1996
;
26
(
10
):
1009
23
.
19.
Bekhbat
M
,
Neigh
GN
.
Sex differences in the neuro-immune consequences of stress: focus on depression and anxiety
.
Brain Behav Immun
.
2018
;
67
:
1
12
.
20.
Oude Elberink
JN
,
de Monchy
JG
,
Golden
DB
,
Brouwer
JL
,
Guyatt
GH
,
Dubois
AE
.
Development and validation of a health-related quality-of-life questionnaire in patients with yellow jacket allergy
.
J Allergy Clin Immunol
.
2002
;
109
(
1
):
162
70
.
21.
Harden
RM
,
Stevenson
M
,
Downie
WW
,
Wilson
GM
.
Assessment of clinical competence using objective structured examination
.
Br Med J
.
1975
;
1
(
5955
):
447
51
.
22.
Sloan
DA
,
Donnelly
MB
,
Schwartz
RW
,
Strodel
WE
.
The Objective Structured Clinical Examination. The new gold standard for evaluating postgraduate clinical performance
.
Ann Surg
.
1995
;
222
(
6
):
735
42
.
23.
Walters
K
,
Osborn
D
,
Raven
P
.
The development, validity and reliability of a multimodality objective structured clinical examination in psychiatry
.
Med Educ
.
2005
;
39
(
3
):
292
8
.
24.
Brockow
K
,
Schallmayer
S
,
Beyer
K
,
Biedermann
T
,
Fischer
J
,
Gebert
N
, et al
Effects of a structured educational intervention on knowledge and emergency management in patients at risk for anaphylaxis
.
Allergy
.
2015
;
70
(
2
):
227
35
.
25.
Sanchez
J
.
Anaphylaxis. How often patients carry epinephrine in real life?
Rev Alerg Mex
.
2013
;
60
(
4
):
168
71
.
26.
Warren
CM
,
Zaslavsky
JM
,
Kan
K
,
Spergel
JM
,
Gupta
RS
.
Epinephrine auto-injector carriage and use practices among US children, adolescents, and adults
.
Ann Allergy Asthma Immunol
.
2018
;
121
(
4
):
479
91
.
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