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

Abstract

AbstractBackgroundPsychiatric co‐morbidity (PCM) constitutes a major complicating factor for patients with hidradenitis suppurativa (HS) but individuals at risk are ill defined.ObjectivesTo examine the differences in demographic and clinical characteristics, co‐morbidities, and disease burden in patients with HS with and without PCM.MethodsData 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.Results667 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.ConclusionsPatients 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.