Study Suggests Allergy Provider Assessments of Psychological Distress Necessary


These data highlight the results of an international sample of adult patients with allergies to certain food products and caregivers of children with food allergies.

Rebecca Knibb

Credit: LinkedIn

Rebecca Knibb

Credit: LinkedIn

New findings suggest that food allergy-related distress is common in many countries, with 67.7% of adults and 77.2% of caregivers reporting direct experience and 51.6% of caregivers saying their child reported psychological distress associated with allergies.1

These conclusions resulted from new research into psychological distress and utilization of related services among adult patients with food allergy. This study looked at both caregivers and children with food allergies, using a global survey which was led by RC Knibb from the Aston Institute for Health and Neurodevelopment at Aston University in Birmingham, UK.

Knibb et al. noted that recent data identified by the team of the Food Allergy Research & Education (FARE) Centers of Excellence in the US suggested few mental health experts are available to whom allergists may send their patients.2

“This article reports on the results of a large international sample of adults with FA and caregivers of children with FA,” Knibb and colleagues wrote. “The main aim of this article was to determine the rates of psychological distress and support needs across different countries, to inform what efforts are necessary to support patients.”

Background and Methods

The investigators used a cross-sectional online survey design, having deemed validated scales evaluating patients’ health-related quality of life (HRQoL) and anxiety as too limited to capture the full scope of psychological issues. To address these gaps, they adapted a questionnaire from a previous study on mental health provider access located within the US.

This revised survey used by the research team was informed by the goals of the GAPS study, a review of existing literature, and iterative feedback provided by the research team, including allergists, psychologists, primary care physicians, methodologists, patients, health services researchers, and representatives from patient organizations. Translations of the team’s questionnaires were also done to ensure their use within the research.

Information related to sociodemographic characteristics of caregivers, adults, and children, associated psychological struggles, food allergy characteristics, allergy-related psychological distress screening during allergy appointments, mental health appointments, and obstacles to mental health access were all recorded. Skip logic was implemented by the team to ensure subjects only answered questions relevant to them.

Those deemed eligible for recruitment in the study were aged 18 and older and caregivers (ages 18+) of children who were aged 0–17 years with self-reported, diagnosed food allergies. The research team facilitated an online survey panel for recruitment, distributing the caregiver questionnaire as an optional survey to potential subjects in the FORWARD Study. Their actions toward recruitment sought to access participants from as many countries as they could, with specific advertising focused on Portugal, Brazil, Australia, France, Germany, Canada, Italy, Spain, the US, and the UK.


Overall, the investigators reported that 67.7% of adults and 77.2% of caregivers had experienced psychological distress linked to food allergy. They also noted that 51.6% of caregivers had been shown to report their children’s experiences of distress, adding that the most commonly noted issue had been anxiety regarding a potential allergic reaction.

The research team expressed that 20% of these children had been given evaluations for psychological distress linked to their allergies. They found notable distinctions across countries regarding screening for distress, interacting with a mental health professional, levels of distress, and a diagnosis of a related mental health disorder (P < .001).

The greatest number of individuals evaluated by the team who had reported being distressed, the investigators found, were Australia, the UK, and Brazil. The team noted that the primary obstacle identified in their research in terms of seeing a mental health expert had been cost.

“Further analysis of the current data is planned in order to explore differences in distress other than country of residence, based on clinical characteristics of allergy in our participant groups,” they wrote. “The next phase of the GAPS study is to develop an online intervention, guided by our findings, to offer psychological support for adults and caregivers.”


  1. Knibb RC, Herbert LJ, Jones CJ, et al. Global availability and uptake of psychological services for adults, caregivers and children with food allergy. Allergy. 2024; 00: 1-11. doi:10.1111/all.16204.
  2. Herbert LJ, Marchisotto MJ, Sharma H, Gupta R, Bilaver LA. Availability of mental health services for patients with food allergy. J Allergy Clin Immunol Pract. 2019; 7(8): 2904-2905. doi:10.1016/j.jaip.2019.04.045.
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