Abstract
Rationale
Over one third of patients have drug allergy labels and the incidence is rising. Emerging data suggest multiple drug allergy labels may be associated with anxiety and depression. We aimed to evaluate whether anxiety or depression were associated with having multiple drug allergy labels using validated screening tools.
Methods
This cross-sectional analysis of adult patients in the United States Drug Allergy Registry (USDAR) (1/9/2019-8/4/2025) collected drug allergy labels (DALs), depression (PHQ-9) and anxiety (GAD-7) scores. We assessed the association of clinically significant depression (PHQ-9 ≥10) and anxiety (GAD-7 ≥10) with number of DALs, overall and stratified by sex.
Results
Among 2048 participants from 6 sites, 1302 (64%) had 1DAL and 746 (36%) had ≥2DALs. Majority were women (1556, 76%), white (1753, 86%) and non-Hispanic (1934, 94%). The mean age was 51±17. Clinically significant depression and anxiety were noted in 141 (7%) and 150 (7%) patients respectively. Compared to those reporting no or mild symptoms, patients with clinically significant depression were more likely to report ≥2DALs (RR 1.29, p=0.009), and those with clinically significant anxiety were more likely to ≥2DALs (RR 1.33, p=0.002). Men with clinically significant depression (RR 1.76, p=0.021) or anxiety (RR 2.28, p=<0.001) were more likely to report ≥2DALs.
Conclusions
Patients with clinically significant anxiety or depression were more likely to report multiple DALs across a multi-site prospective sample. These findings support the need to incorporate mental health screening into drug allergy evaluations.