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development of asthma symptoms. Ann Ital Med Int. 2004; 19(2): 98-108. 13. Yukselen A, Kendirli SG, Yilmaz M, Altintas DU, Karakoc GB. Two year follow-up of clinical and inflammation parameters in children monosensitized to mites undergoing subcutaneous and sublingual immunotherapy. Asian Pac J Allergy Immunol. 2013; 31(3): 233. 14. Ciprandi G, Cirillo I. Monosensitization and polysensitization in allergic rhinitis. Eur J Int Med. 2011; 22(6): e75-79. 15. Passalacqua G. The use of single versus multiple antigens in specific allergen immunotherapy for allergic rhinitis: review of the evidence. Curr Opin Allergy Clin Immunol. 2014; 14(1): 20-24. 16. Cox L, Jacobsen L. Comparison of allergen immunotherapy practice patterns in the United States and Europe. Ann Allergy, Asthma Immunol. 2009; 103(6): 451-460. 17. Migueres M, Dávila I, Frati F, et al. Types of sensitization to aeroallergens: definitions, prevalences and impact on the diagnosis and treatment of allergic respiratory. Anxiety and depression risk in patients with allergic rhinitis: a systematic review and meta-analysis* Abstract Background: Allergic diseases appear to be associated with mood disorders. However, particularly regarding allergic rhinitis (AR), such association has not been adequately systematically reviewed. Therefore, we conducted a systematic review and meta-analysis to quantify the association between AR and depression and anxiety. Methodology: We performed an electronic search of PubMed, Web of Science and Scopus for observational studies assessing the association between AR and depression and anxiety. Such association was quantified by means of random-effects meta-analysis, with estimation of pooled odds ratio (OR). Sources of heterogeneity were explored by subgroup analysis. Results: We included a total of 24 primary studies, of which 23 assessed depression and 11 assessed anxiety. Of these, 12 studies presented OR from multivariable regression models and were included in our meta-analysis. AR was associated with higher odds of depression and anxiety. Conclusions: AR appears to be associated with high risk of depression and anxiety. While our results point to the importance of mental comorbidities among patients with AR, longitudinal studies are needed adopting uniform definitions and presenting results stratified by AR severity. Key words: allergic rhinitis, allergy, anxiety, depression, mental health J. Rodrigues1,2,3, F. Franco-Pego3,4, B. Sousa-Pinto3,4, J. Bousquet5,6,7, K. Raemdonck2,3,8, R. Vaz1,2,3 1 Otorhinolaryngology Department, Centro Hospitalar Universitário de S. João, EPE, Porto, Portugal. 2 Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal. 3 CINTESIS – Center for Health Technology and Services Research, University of Porto, Porto, Portugal. 4 MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal. 5 Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany. 6 Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin Institute of Health, Berlin, Germany. 7 MACVIA-France, Montpellier, France. 8 CESPU – Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS), Gandra, Portugal Rhinology 59: 4, 360 - 373, 2021 https://doi.org/10.4193/Rhin21.087 *Received for publication: March 7, 2021 Accepted: May 26, 2021 360 Introduction Allergic rhinitis (AR) affects more than 400 million people worldwide(1). In Europe, its prevalence is approximately 25%, being even higher in urban areas(1,2). Allergic rhinitis and its comorbidities are often overlooked, underdiagnosed and undertreated(3). In fact, despite not being a life-threatening disease, AR has important consequences on
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