RESEARCH FINDINGS USING GUIDED IMAGERY FOR

CHILDREN WITH ALLERGIES

September, 2006


Definition of the Problem

Pediatric allergies affect more than 20% of school age children (National Panel, 1999). Types of allergies include allergic rhinitis, atopic eczema and dermatitis, and allergies to food, pets, and insect stings. Allergies frequently contribute to childhood asthma, chronic otitis media, and sinusitis (Settipane, 1999).

Allergy symptoms include itching, sneezing, runny nose, rash, itching, and cough. Allergies can also cause fatigue, difficulty concentrating and thinking, and insomnia, all of which can significantly affect patients’ quality of life (Klein, Ziering, et al, 1985; Settipane).

Scope of the Problem

According to the American Academy of Allergy, Asthma and Immunology, allergies rank sixth in cost on the list of chronic diseases in the United States (The Allergy Report, 2001). Approximately 20% of American children have allergies (National Panel, 2001). In a given year, 6.7 (9.2%) of children are diagnosed as having hay fever (NCHS, 2004).

Allergic rhinitis affects approximately 40% of children (Dykewicz and Fineman, 1998). Atopic dermatitis is the most common skin problem in children under age eleven (AAAAI Media Kit, undated). If both parents have allergies, there is a 70% chance that their child will also have allergies (Allergy and Asthma Foundation, undated).

Each year, American children lose 2 million school days because of allergies (National Panel, 1999). While no specific cost figures are available for pediatric allergies, the total treatment cost of allergies in the United States is about $2 billion a year. There are 14.1 million office visits a year just for allergic rhinitis, with estimated direct and indirect costs of $6 billion in 1996 (AAAAI Media Kit, undated).


Medical Treatment

Standard medical treatment for allergies includes antihistamines, decongestants, steroids, cromolyn (in the respiratory tract), skin ointments, eye drops, decongestant and antihistamine nasal sprays, and newer medications including leukotriene receptor antagonists. None of these medications cure allergies, and all oral medications have significant side effects.

Antihistamines cause drowsiness, although newer drugs are less sedating. Decongestants raise blood pressure and heart rate, and steroids can cause a variety of physical and mental symptoms. Allergy shots do reduce sensitivity to allergens in some patients, but the shots are expensive, require frequent clinic visits, and do not work for a significant group of patients (Ivker, 1995).


Complementary Treatment including Imagery and Self-Hypnosis

The causes of allergy include hereditary tendencies, past and present environment, and stress (Ivker, 1995). Anxiety is strongly linked to allergies, especially rhinitis and dermatitis (Addolorato, Ancona, et al, 1999; Czubalski and Zawisza, 1976; Michel, 1994; Weir, 1976).

Anti-anxiety programs including relaxation and guided imagery have been used with great success in allergic dermatitis (Ehlers, Stangier, and Gieler, 1995; Klein, Ziering, et al, 1985; Shertzer and Lookingbill, 1995; Stewart and Thomas, 1995).
In one study, 19 out of 20 children showed immediate improvement in their severe, resistant atopic dermatitis after using hypnotherapy (Stewart and Thomas).

These methods have been less studied in allergic rhinitis (AR), probably because treatment results are harder to measure in AR than they are in dermatitis. However, when Madrid et al. taught a two-session course in self-hypnosis to a group of 34 patients with a variety of allergies, 76% reported improvement, and 86% reduced medication use.

Improvement was maintained through two years of follow-up (Madrid, Rostel, et al, 1995). Behavioral approaches with demonstrated effectiveness include cleaning and ventilation to reduce allergens, allergen avoidance, regular relaxation, exercise and healthier eating (Ivker, 1995).


Conclusion

Guided imagery can improve children’s ability to cope with allergies, and reduce allergy symptoms, office visits, and medication use in many cases.

REFERENCES

Addolorato G, Ancona C, Capristo E, Graziosetto R, Di Rienzo L, Maurizi M, Gasbarrini, G. State and trait anxiety in women affected by allergic and vasomotor rhinitis. J Psychosom Res. 1999 46(3):283-289.

Allergy and Asthma Foundation of America (undated). Qtd. on: Allergy, Asthma & Immunology. Yale Medical Group.
http://ymghealthinfo.org/content.asp?page=P01690
September, 2006.

Allergies/Hay Fever. Fastats.
Centers for Disease Control and PreventionNational Center for Health Statistics.
http://www.cdc.gov/nchs/fastats/allergies.htm
Accessed September, 2006.

[no authors listed] Allergies Health Guide. University of Maryland Medicine.
www.umm.edu/allergies/stats.htm Accessed September, 2006.

[no authors listed] The Allergy Report: Science Based Findings on the Diagnosis & Treatment of Allergic Disorders
, 1996-2001. American Academy of Allergy, Asthma and Immunology (AAAAI). Qtd on:
www.aaaai.org/media/resources/media_kit/allergy_statistics.stm
Accessed September, 2006.

Czubalski K, Zawisza E. The role of psychic factors in patients with allergic rhinitis. Acta Otolaryngol. 1976 81(5-6):484-8.

Dykewicz MS, Fineman S. Executive Summary of Joint Task Force Practice Parameters on Diagnosis and Management of Rhinitis. Ann Allergy Asthma Immunol. 1998 Nov;81(5 Pt 2):463-8.

Ehlers A, Stangier U, Gieler U. Treatment of atopic dermatitis: a comparison of psychological and dermatological approaches to relapse prevention.
J Consult Clin Psychol. 1995 Aug;63(4):624-35.

Ivker, Robert DO. (1995).
Sinus Survival (3rd Edition) New York: Jeremy Tarcher. p. 65-68.

Klein GL, Ziering RW, Girsh LS, Miller MF. The allergic irritability syndrome: four case reports and a position statement from the Neuroallergy Committee of the American College of Allergy.
Ann Allergy. 1985 Jul;55(1):22-4.

[no authors listed] National Panel of Allergists Concludes Parents Play Key Role in Minimizing Impact of Children’s Allergies. KidSource Online. University of Cincinnati Medical Center. 1999 April 22.
www.kidsource.com/kidsource/content5/allergies.html
Accessed September, 2006.

Settipane RA. Complications of allergic rhinitis.
Allergy Asthma Proc. 1999 20(4):209-13.

Madrid A, Rostel G, Pennington D, Murphy D. Subjective assessment of allergy relief following group hypnosis and self-hypnosis: a preliminary study. Am J Clin Hypn. 1995 Oct;38(2):80-6.

Michel FB. Psychology of the allergic patient.
Allergy. 1994 49(18 Suppl):28-30.

Shertzer CL, Lookingbill DP. Effects of relaxation therapy and hypnotizability in chronic urticaria.
Arch Dermatol. 1995 123(7):913-6.

Stewart AC, Thomas SE. Hypnotherapy as a treatment for atopic dermatitis in adults and children.
Br J Dermatol. 1995 132(5):778-83.

Weir NF, Stephens SD. Personality measures in E.N.T. outpatients.
J Laryngol Otol. 1976 90(6):553-60.