Quality of life and psychological wellbeing of adults with anaphylaxis: a mixed method systematic review.
Arbuckle B, Forster E, Mitchell A • Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation • 2026
Anaphylaxis negatively affects adults' psychological wellbeing and quality of life, with most studies reporting high levels of stress, anxiety, and/or depression, daily limitations, and reduced enjoyment in social activities driven by fear and emotional burden from previous episodes.
Key Findings
Results
Most studies found that anaphylaxis has a negative impact on adults' psychological wellbeing, with many experiencing high levels of stress, anxiety, and/or depression.
11 papers (10 studies) met the inclusion criteria from a search of 9 databases covering January 2011 to October 2024.
The Mixed Methods Appraisal Tool was used to assess methodological quality.
A convergent mixed methods design was used to analyse data from included studies.
The review was prospectively registered on PROSPERO (2024 CRD42024583368).
Results
Women with anaphylaxis reported worse mental health outcomes than men.
This gender difference in psychological wellbeing was identified across the included studies.
This finding emerged from the convergent mixed methods synthesis of 10 studies.
The review did not restrict by country or setting, suggesting this may be a generalizable finding.
Results
Quality of life was impaired in adults with anaphylaxis, with most participants reporting daily limitations and many expressing reduced enjoyment in social activities.
Daily limitations were reported by most participants across included studies.
Reduced enjoyment in social activities was a commonly reported outcome.
Impaired QOL was attributed to fear and emotional burden arising from previous episodes of anaphylaxis.
These findings were synthesised from 11 papers (10 studies) identified through a comprehensive nine-database search.
Results
Fear and emotional burden from previous anaphylaxis episodes contributed to avoidant behaviours and social withdrawal as strategies to reduce the risk of future events.
Avoidant behaviours and social withdrawal were identified as responses to the psychological impact of anaphylaxis.
These behaviours were linked to impaired quality of life rather than improved safety outcomes in the reviewed literature.
This pattern was identified through the convergent mixed methods analysis of quantitative and qualitative data from included studies.
Conclusions
The review concluded that clinicians may consider routine assessment of QOL and psychological wellbeing in adults with anaphylaxis to identify patients who may require additional support.
The recommendation arose from the finding that psychological burden and impaired QOL are common but may not be routinely assessed in clinical practice.
The authors noted this is to 'not only provide adequate support but to identify patients who may require additional support as they learn to balance daily living with anaphylaxis.'
The review used PRISMA guidelines and searched nine databases to ensure comprehensive evidence synthesis.
What This Means
This research synthesised findings from 10 studies published between 2011 and 2024 to understand how anaphylaxis — a severe, life-threatening allergic reaction — affects the mental health and quality of life of adults. The researchers found that most adults living with anaphylaxis experience significant psychological distress, including high levels of stress, anxiety, and depression. Women tended to report worse mental health than men. Beyond emotional wellbeing, anaphylaxis also affected day-to-day life, with most people reporting limitations in daily activities and reduced enjoyment of social situations.
A key pattern that emerged was that the fear of having another anaphylaxis episode — rather than just the episodes themselves — drove many people to avoid activities and withdraw socially. While this may feel like a protective strategy, it contributes to a reduced quality of life. The emotional weight of managing a potentially life-threatening condition appears to shape how people live, sometimes in ways that limit their participation in normal life.
This research suggests that healthcare providers who care for people with anaphylaxis might consider routinely checking in on their patients' mental health and quality of life, not just their physical allergy management. Identifying people who are struggling emotionally could allow for earlier support and help people find ways to manage their condition while still engaging fully in daily life.
Arbuckle B, Forster E, Mitchell A. (2026). Quality of life and psychological wellbeing of adults with anaphylaxis: a mixed method systematic review.. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. https://doi.org/10.1007/s11136-026-04266-0