The relationship between anxiety and quality of life in children with hereditary angioedema.

Background The severe life-threatening characteristics of hereditary angioedema ( HAE) with C1-inhibitor deficiency (C1- INH- HAE) can affect anxiety levels among pediatric patients. This emotional burden together with the physical restrictions of C1- INH- HAE may decrease children's health-related quality of life ( HRQoL). Objectives (i) To compare anxiety state and trait between children with C1- INH- HAE and healthy controls; (ii) to examine the relationship between the level of anxiety of children with C1- INH- HAE, their disease activity/affected sites and their HRQoL; and (iii) to predict the HRQoL of children with C1- INH- HAE based on their anxiety level and disease activity/affected sites Methods Thirty-three children with C1- INH- HAE (aged 5-18 years) and 52 healthy controls were recruited from Israel and Hungary. All children completed the State-Trait Anxiety Inventory for Children ( STAIC), the Pediatric Quality of Life Inventory (Peds- QL) demographic questionnaire and a disease activity and site questionnaire . Disease activity was defined as the number of attacks in last year. Results Both anxiety state and trait were significantly higher among children with C1- INH- HAE as compared to the controls (44.74±10.56 vs 38.76±10.67, P<.01, 29.21±5.16 vs 25.23±4.09, P<.001 in comparison). Significant differences were found between C1- INH- HAE patients with HAE attacks, asymptomatic C1- INH- HAE patients, and healthy controls in both anxiety state ( F_56,2=4.69, P=.001) and trait ( F_56,2=9.06, P<.0001). A higher anxiety trait was correlated with the number of angioedema-affected sites ( r=.52, P=.003). The presence of HAE attacks and higher anxiety trait predicted a lower HRQoL in children with C1- INH- HAE. Conclusions C1- INH- HAE children have higher anxiety trait and state, which correlate with reduced HRQoL domains. [ABSTRACT FROM AUTHOR]