Depression and Anxiety Common in Patients With Hidradenitis Suppurativa

Physicians may need to be sensitive to depression and anxiety in their patients with hidradenitis suppurativa.

A study found relatively high rates of depression and anxiety in patients with hidradenitis suppurativa (HS), suggesting that psychiatric conditions may be additional targets for managing patients with HS. Findings from this study were published in JAMA Dermatology.

A meta-analysis was performed for 10 observational studies that reported both prevalence and odds of depression and anxiety in adult patients with HS (n=40,307). The primary outcome measures for analysis were the pooled odds and prevalence rates of depression and anxiety in this patient population.

In the overall cohort, the prevalence of depression and anxiety were 16.9% (95% CI, 9.9%-27.2%) and 4.9% (95% CI, 1.7%-13.2%), respectively. Heterogeneity across studies was high for depression (I2=99.4%) and anxiety (I2=99.1%).

The prevalence of depression was highest in studies that used a screening instrument for the disorder (26.8%; 95% CI, 20.4%-34.5%) compared with studies that used a clinical criteria–based diagnosis (11.9%; 95% CI, 4.9%-26.2%). Compared with patients without HS, the pooled odds ratio (OR) for depression in patients with HS was 1.84 (95% CI, 1.57-2.15). The adjusted OR for anxiety in 2 studies that included a comparison group was 1.7. Because of the comparison groups in the 2 studies, the researchers were unable to determine an OR for anxiety in patients with HS.

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Limitations of the analysis were the inclusion of studies featuring disparities in depression prevalence rates between diagnostic instruments, as well as the variation in the methodological quality of the analyzed studies.

Although a causal relationship between psychiatric disorders and HS has yet to be proved, the researchers suggest “efforts should be directed to recognizing and treating those psychiatric comorbidities in patients with HS to improve health outcomes.”


The authors disclosed financial relationships with AbbVie, Janssen, Novartis, Celgene, Naos, Lilly, Sanofi, and Valeant.

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Machado MO, Stergiopoulos V, Maes M, et al. Depression and anxiety in adults with hidradenitis suppurativa: a systematic review and meta-analysis [published online June 5, 2019]. JAMA Dermatol. doi:10.1001/jamadermatol.2019.0759