DOI: https://doi.org/10.36347/sjams.2025.v13i07.018

Pages: 1454-1463

Background: Chronic urticaria (CU) is a skin disorder characterized by recurrent wheals (hives) and/or angioedema lasting ≥6 weeks[1]. Beyond the physical symptoms, CU is believed to adversely affect mental health. We conducted a systematic review following PRISMA guidelines to assess the prevalence of anxiety and depression among adults with chronic urticaria over the past 20 years (2005–2025). Methods: We searched PubMed, Scopus, and Web of Science (2005–2025) for studies reporting anxiety and/or depression prevalence in adult CU patients. Eligibility criteria included: (1) adult population (≥18 years) with chronic urticaria, (2) reported prevalence of clinically diagnosed or questionnaire-defined anxiety or depression, (3) any geographic region or language. Studies on pediatric patients were excluded. Data on sample size, setting, assessment tools, and prevalence outcomes were extracted. We limited the final included studies to <10 for feasibility. Quality was appraised descriptively, and results were synthesized narratively with a summary table of key findings. Results: Eight studies (total n ≈ 170,000, including one large population-based dataset) met inclusion criteria. Prevalence of anxiety and depression in CU patients varied widely across studies, reflecting differences in assessment methods and populations. In specialist clinic samples, approximately 30–50% of CU patients had anxiety or depressive symptoms[2,3]. For example, two independent studies using the Hospital Anxiety and Depression Scale (HADS) reported anxiety and/or depression in about 48% of patients[2,3]. A recent small case-control study found 70% of CU patients had moderate-to-severe depression and 46% had anxiety, significantly higher than in healthy controls (27% and 23%, respectively)[4]. In contrast, large epidemiologic studies requiring clinical diagnoses reported lower absolute prevalence: e.g. 9.7% for depression and 5.0% for anxiety in an outpatient cohort[5], which is still elevated