LIVING with food allergies (FA) significantly impacts quality of life (QoL) across childhood, adulthood, and parenthood. Critical periods, such as diagnosis, oral FA challenges, and life transitions (e.g., moving schools or desensitization), heighten psychological needs, causing emotional distress and requiring tailored support. For parents, the diagnostic journey is particularly stressful, with one-third experiencing anxiety and 17.5% depression before diagnosis. Prolonged testing and the responsibility of managing multiple or ubiquitous allergies intensify stress, guilt, and worry. Parents often struggle to “hand over” care to others due to the ever-present risk of anaphylaxis, compounding anxiety and impairing QoL.
Children and young people (CYP) also face significant challenges. Diagnostic journeys can provoke distress and fears, while living with multiple or staple food allergies leads to stigma, bullying, and isolation. Interestingly, emotional distress for some CYP and parents subsides post-food challenges, regardless of the outcome. Conversely, adults with FA are less studied, though emerging research highlights anxiety and post-traumatic stress disorder (PTSD) risks following anaphylaxis. Despite assumptions of greater resilience, adults diagnosed later in life may adapt less effectively than CYP, who often develop coping skills earlier with family and professional support.
Specialist psychological interventions remain limited despite evidence of need. Cognitive Behavioural Therapy (CBT) has shown promise, particularly for parents, in addressing anxiety and maladaptive behaviours. A recent study trialled an online, low-intensity group CBT intervention for parents, CYP, and adults with FA, yielding positive signals for improving FA-specific QoL. Notably, parental anxiety improved initially, while adults reported better problem-focused coping and reduced depression over 3 months. However, changes in CYP mechanisms like worry and coping behaviours were not observed, suggesting a need for FA-specific assessment tools.
The intervention’s accessibility and group format make it a promising addition to stretched allergy services, offering peer support alongside therapeutic benefits. Future research should prioritise diverse participant demographics and explore clinical and cost-effectiveness. Addressing these gaps could improve QoL for individuals with FA, ensuring broader access to psychological support.
Katie Wright, EMJ
Reference
Jones CJ et al. Online, group, low-intensity psychological intervention for adults, children, and parents with food allergy. Ann Allergy Asthma Immunol. 2024;133(4):453-61.
