D2.231 - Psychological Profiles and Personality Traits in Chronic Spontaneous Urticaria: A Pilot Study

Chronic urticaria remains clinically challenging, as standard allergy testing and screening for underlying diseases fail to identify a primary cause in most patients, who therefore are classified as having chronic spontaneous urticaria (CSU). Psychiatric comorbidities are frequently reported in patients with CSU, with anxiety and depression being among the most frequently co-occurring mental disorders. The aim of this pilot study was to characterize the psychological profiles of patients with CSU and to explore whether specific personality traits are associated with personality disorders.

Patients with chronic urticaria and a negative preliminary workout excluding an identifiable underlying disease, were invited to participate in this study. A cohort of 22 adults diagnosed with CSU (mean age 41.5 years; range 20–65 years) was assessed using the Personality Diagnostic Questionnaire–4+ (PDQ-4+). PDQ-4+ is a validated 99-item self-report tool for screening personality disorders. A control group of 10 healthy individuals with no history of chronic dermatologic or psychiatric conditions completed the same questionnaire. Responses were analyzed to assess the prevalence and distribution of personality disorders between the two groups.

Psychological disorders were identified in the vast majority (19/22) of CSU patients. Obsessive–compulsive personality disorder (OCPD)–related traits were the most frequently observed personality features in the CSU group and were more prevalent compared with healthy controls. Compared with healthy participants, CSU patients exhibited higher scores across compulsive, anxiety-, and mood-related domains, than controls. These findings suggest a potential association between CSU and underlying personality factors, which may contribute to disease persistence.

This pilot study is consistent with previous studies indicating a high prevalence of personality-related disturbances among patients with CSU. The PDQ-4+ questionnaire was proved useful to detect differences between CSU patients and healthy controls, however it appears to be time-consuming. Ongoing research will include a larger patient cohort and additional validated psychological instruments to refine the psychosomatic characterization of CSU and support multidisciplinary management strategies.