D2.236 - Alexithymia and Depression in Patients with Chronic Spontaneous Urticaria Treated with Omalizumab

Chronic spontaneous urticaria (CSU) is a chronic inflammatory skin disease characterized by recurrent wheals and/or angioedema, leading to significant impairment in quality of life. Although psychological factors are known to influence disease course, data regarding alexithymia and depression in CSU patients receiving omalizumab remain limited. This study aimed to evaluate alexithymia and depression levels in omalizumab-treated CSU patients compared with healthy controls and to assess their associations with disease activity, disease control, and quality of life.

Twenty-seven patients with CSU receiving omalizumab therapy and healthy controls were included in the study. Disease activity was assessed using the Urticaria Activity Score over 7 days (UAS7), disease control using the Urticaria Control Test (UCT), and quality of life using the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL). Depression was evaluated using the Beck Depression Inventory (BDI), and alexithymia was assessed with the 20-item Toronto Alexithymia Scale (TAS-20). Written informed consent was obtained from all participants.

Patients with CSU demonstrated significantly higher depression and alexithymia scores compared to healthy controls. Mean BDI scores were 12.1 ± 6.8 in the patient group and 6.8 ± 6.7 in controls (p = 0.003). The mean TAS-20 total score was 54.4 ± 10.7 in patients versus 40.5 ± 12.2 in controls (p < 0.001). A significant positive correlation was observed between disease activity (UAS7) and depression severity (r = 0.39, p = 0.046). No significant associations were found between alexithymia scores and disease activity, disease control, or quality of life measures (p > 0.05).

Despite treatment with omalizumab, patients with CSU exhibit higher levels of depressive symptoms and alexithymic traits compared to healthy individuals. The association between disease activity and depression highlights the close interaction between psychological factors and clinical severity in CSU, while alexithymia appears to be independent of disease-related parameters.