A Cross-Sectional Study on Relationships Between Depression and Anxiety in Hidradenitis Suppurativa Patients and Disease Severity, Subjective Symptoms and Quality of Life

TL;DR

This study finds that depression and anxiety are common in hidradenitis suppurativa patients and are linked to disease severity and lower quality of life.

Contribution

The study establishes new associations between depression/anxiety and both clinical severity and subjective symptoms in HS patients.

Findings

Depressive symptoms were found in 25% of patients and correlated with disease severity and quality of life.

Anxiety symptoms were present in 15.5% of patients and linked to disease severity, pain, and itch intensity.

Psychological measures showed strong correlations with quality of life indicators in HS patients.

Abstract

Background/Objectives: Hidradenitis suppurativa (HS) is a chronic, inflammatory, and recurrent disorder of the pilosebaceous unit with numerous comorbidities. Growing evidence suggests that depression and anxiety occur more frequently in HS patients, yet their relationship with clinical severity and especially subjective symptoms remains insufficiently understood. The aim of this study was to assess the prevalence and severity of probable depressive and anxiety symptoms in Polish patients with HS and to examine their associations with clinical disease severity, pain and itch intensity, and quality of life (QoL). Methods: Eighty-four HS patients were included in this cross-sectional study. Disease severity was assessed using Hurley staging and the IHS4. Pain and itch intensity were evaluated using the Numeric Rating Scale (NRS). Psychological assessment included self-administered screening questionnaires, such as PHQ-9 and HADS-D for depression and GAD-7 and HADS-A for anxiety. QoL was measured using DLQI and HiSQOL instruments. Statistical analyses were performed with p < 0.05 considered significant. Results: Possible depressive disorders were identified in 25.0% of patients. PHQ-9 and HADS-D scores differed significantly across Hurley stages and correlated positively with IHS4. Possible anxiety disorder according to GAD-7 criteria was present in 15.5% of patients. Both GAD-7 and HADS-A correlated with IHS4. They also showed correlations with pain and/or itch intensity. All psychological measures showed strong correlations with both QoL instruments. Conclusions: Depression and anxiety seem to be common in HS and closely associated with clinical severity and reduced QoL. Their relation with pain and itch requires further studies. These findings underscore the need for multidisciplinary management in HS care.

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