Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Allergy Unit

Student research

Exploring characteristics in adult patients starting the RPAH Elimination Diet and Challenge Protocol: A qualitative study

Anna-Jane Debenham
Master of Nutrition and Dietetics, The University of Sydney
Supervisors: Velencia Soutter, Robert Loblay, Anne Swain, Brooke McKinnon, Carling Chan, Kirsty Le Ray, Wendy Stuart-Smith
October 2014

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Aim: Psychological factors may influence one's ability to adhere to the Royal Prince Alfred Hospital (RPAH) Elimination Diet and Challenge Protocol (ED&CP). This study aimed to determine the prevalence of anxiety, depression and eating disorders in patients attending the RPAH Allergy Unit, and evaluate the validity of the RPAH Allergy Unit Assessment Form (RAAF) in identifying these disorders. This was used to determine whether psychological factors influence dietary adherence to the RPAH ED&CP. Furthermore, this study sought to explore other personality traits, food beliefs and habits of patients and determine if these were indicative of one's ability to commence the RPAH ED&CP.

Methods: This study is part of a five-year cross-sectional study. A series of validated questionnaires were used to determine the psychological status of patients. Patients' four-day weighed food records on the RPAH ED&CP were used to determine any relationship between dietary adherence and psychological status. Demographic, social, personality and clinical information were collected via the RAAF to determine other personality traits of patients.

Results: Means and standard deviations for anxiety, depression and eating disorders in patients (n = 90) prior to the RPAH ED&CP were 38 ± 12, 10 ± 8 and 0.9 ± 1.0, respectively. Of the patients who were assessed for dietary adherence (n = 28), 68 % were adherent, 14 % partially adherent and 18 % non-adherent and this did not appear to associate with psychological symptoms.

Conclusion: The distribution of depression, anxiety and eating disorders in patients prior to starting RPAH ED&CP was similar to the general adult population. No apparent relationship was evident between depression, anxiety and/or eating disorders and patients' dietary adherence. The RAAF may be useful for screening patients for depression.