Addressing psychological issues (Table 4)
Many AYA with allergy and/or asthma have co-existing psychological
issues, including anxiety, depression, suicidal ideation, and relational
difficulties.33,57-74 These problems may magnify the
complexities of self-management, care coordination and treatment
planning in AYA with allergy and/or asthma. Therefore, the
identification and management of psychological issues impacting disease
control and health-related quality of life can be recommended (Grade B).
It is known that the social context of a person’s life determines the
risk of exposure, as well as their susceptibility, the course and
outcome of illness.75,76 Socioeconomic factors and
stressful life events can impact disease
control34,77-81 and HRQL in allergic
diseases64,70,82,83. Therefore, the identification and
management of socioeconomic issues and stressful life events impacting
disease control and HRQL may be recommended (Grade C).
Where AYA are struggling to successfully self-manage their asthma,
psychological interventions using a CBT based or multi-systemic therapy
approach can be recommended to improve asthma knowledge, improve
adherence, self-management and symptom control (Grade
B).39-42 This is based on a small number of randomised
controlled asthma trials. Similar approaches are likely to be helpful
where allergy is the key problem.