JEADV Clinical Practice (Dec 2023)

Psychiatric co‐morbidity in patients with hidradenitis suppurativa: A cross‐sectional study of clinical characteristics and burden of disease

  • Nikolaj Holgersen,
  • Valdemar Wendelboe Nielsen,
  • Hans Christian Ring,
  • Nana Aviaaja Lippert Rosenø,
  • Alexander Egeberg,
  • Jacob Pontoppidan Thyssen,
  • Simon Francis Thomsen

DOI
https://doi.org/10.1002/jvc2.222
Journal volume & issue
Vol. 2, no. 4
pp. 994 – 1004

Abstract

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Abstract Background Psychiatric co‐morbidity (PCM) constitutes a major complicating factor for patients with hidradenitis suppurativa (HS) but individuals at risk are ill defined. Objectives To examine the differences in demographic and clinical characteristics, co‐morbidities, and disease burden in patients with HS with and without PCM. Methods Data were obtained through clinical examination and interviews. Disease burden was evaluated based on clinical severity, VAS‐10 for overall bother and pain, and dermatology life quality index. Analysis was conducted on all patients and amongst PCM‐subgroups. All current physician diagnosed psychiatric conditions were included. Results 667 consecutive, adult patients with HS from a dermatological university outpatient clinic were included. Of these, 183 (27.4 %) had a diagnosis of PCM, with affective disorders (16.2%) being most prevalent. PCM was associated with being unemployed (52.5 vs. 18.7 %) OR 5.50 (3.73–8.10) p < 0.001, Caucasian (88.5 vs. 80.6 %) OR 1.86 (1.12–3.09) p < 0.05, younger at HS‐onset (23.6 vs. 26.2 years) p < 0.01, obese (44.0 vs. 34.5 %) OR 1.50 (1.06–2.13) p < 0.05 and smoker (89.6 vs. 73.2 %) OR 3.76 (2.20–6.40) p < 0.001. Differences within PCM‐subgroups were also discovered. Patients with PCM were more likely to have asthma or/and chronic obstructive pulmonary disease (9.8 vs. 5.6 %) OR 1.94 (1.03–3.66) p < 0.05. Patients with PCM had higher VAS‐10 bother scores (mean 7.3 vs. 6.7) p < 0.05, but no differences in disease severity. Patients with HS‐onset before the age of 15 had the highest risk of developing PCM within the following 10 years, HR 3.37 (1.56–7.31) p = 0.002. Conclusions Patients with PCM and HS vary in demographic and clinical characteristics, risk factors and burden of disease, compared to patients with HS without PCM. This calls for a multidisciplinary approach and increased awareness from the clinician.

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