Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL USA; Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC USA. Electronic address: JonathanISilverberg@Gmail.com.
BACKGROUND: Previous studies found conflicting results about whether hidradenitis suppurativa (HS) is associated with depression or anxiety.
OBJECTIVES: Determine the relationship of HS with depression and anxiety.
METHODS: A systematic review was performed of published observational studies in MEDLINE, Pubmed, EMBASE, GREAT, LILACS, Cochrane, Scopus and PsychInfo that analyzed depression or anxiety in HS. Two reviewers performed title/abstract review and data extraction. Meta-analysis was performed using random-effects weighting.
RESULTS: Thirty-nine studies met inclusion criteria; 27 had sufficient data for meta-analysis. The prevalences of depression (26.6% vs. 6.6%) and anxiety (18.1% vs. 7.1%) were higher in persons with vs. without HS. HS patients had higher odds of depression in 12 of 13 studies and pooled analysis (odds ratio [95% confidence interval]: 2.54 [2.15-3.01]), and anxiety in 6 of 6 studies and pooled analysis (2.00 [1.66-2.42]). Similar results were found in sensitivity analyses for different methods of HS diagnosis (physician diagnosed and chart review) and control groups (healthy and dermatologic controls). HS was associated with higher anti-depressant and anxiolytic use, and suicidality, but not mean depression and anxiety scale scores. LIMITATIONS: Individual level data were unavailable.
CONCLUSIONS: HS patients have higher odds of depression, anxiety, and suicidality.