Effects of anxiety and depression on the evaluation of allergic rhinitis treatment and a two-sample Mendelian randomization analysis
Wang Ying
Zhang Mingsheng
Che Changwen
Xin Zhonghai
Abstract：Objective To observe the treatment effect on allergic rhinitis(AR)in patients with concomitant anxiety and depression,to analyze the influence of emotional disorders on the outcome of AR,and to explore the causal relationship between AR and anxiety and depression.Methods A retrospective analysis was conducted on a total of 179 cases that met the diagnostic criteria for AR with completed medical records in the Otolaryngology Department of Changping District Integrated Traditional Chinese and Western Medicine Hospital from January 2019 to June 2024.There were 97 cases in the comorbidity group with anxiety and depression,and 82 cases in the rhinitis group.General information,such as age and gender,was collected.AR symptom scores in TNSS,VAS,Lund-Kennedy endoscopy and TMS,as well as SAS,SDS and RQLQ scores were tabled.The baseline values of general information were compared.Scores before and after AR treatment,including objective and subjective scores for nasal symptoms and for quality of life,were compared among patients and between groups.And the sub-items of TNSS,VAS,and RQLQ were also compared.Treatment efficiency was calculated by the way of:(pre-treatment score-post-treatment score)/pre-treatment score.Using GWAS summary data as the outcome factor of AR,the two-sample Mendelian randomization(MR)method was used to evaluate the causal effect relationship of anxiety and depression with AR.Results After AR treatment,the scores of TNSS,VAS,RQLQ,and LK decreased,and were statistically different(all P<0.05),indicating that the treatment was effective for all enrolled cases.Before treatment,there were statistical differences in the scores of AR subjective symptoms in terms of sneezing,nasal congestion,sleep,and emotion,and the scores of cases in the comorbidity group were higher than those in the rhinitis group(all P<0.05).After treatment,there were statistical differences in the scores of AR subjective symptoms in all aspects,and the scores of cases in the comorbidity group were higher than those in the rhinitis group(all P<0.05).Before and after treatment,there were no statistical differences in the objective scores of AR signs between groups(all P≥0.05).There were statistical differences in the treatment improvement rates in all aspects of subjective symptoms,and the treatment improvement rate of cases in the comorbidity group was lower than that in the rhinitis group(all P<0.05),but there was no statistical difference in the objective sign scores between the two groups(all P≥0.05).There was a contradiction between the improvement rates of AR treatment in terms of objective sign and subjective symptom evaluations in the two groups.In two-sample MR analysis,the IVW results suggested that depression did not increase or decrease the risk of AR,and there was no clear causal relationship between depression and AR.The results of MR Egger,weighted median,and weighted mode were consistent with the IVW results in direction,and the results were stable.The simple mode results suggested that anxiety did not increase or decrease the risk of AR(P=0.063).Conclusion In the case of receiving the same treatment and obtaining the same objective sign improvement,the subjective experience of the treatment effect on nasal symptoms in patients with comorbid anxiety and depression and AR is worse than that in rhinitis patients without concurrent anxiety and depression emotional disorders.There is no significant correlation of anxiety and depression with the occurrence of AR.Anxiety and depression emotional disorders or mental illnesses do not increase the risk of suffering from AR.
Keywords：Allergic rhinitisAnxietyDepressionMendelian randomization
Publication Date：2025-07-27
Online Publishing Date：2025-12-22(First online date of this platform, not the publication date of the document)
Pages：7( 1-7 )