Patients with hidradenitis suppurativa at risk of developing depression

Hidradenitis suppurativa (HS) in children, adolescents, and adults significantly increases the risk for new-onset depression, independent of other common risk factors for depression, suggests a study.

This retrospective cohort analysis sought to compare the risk of new-onset depression in HS patients with that of control individuals. Using electronic health record data, the investigators identified 49,280 adults and 3,042 paediatric patients with HS and matched controls. Incident depression was the primary outcome.

The crude incidence rate of new-onset depression was 4.8 per 100 person-years in adult patients with HS compared to 3.0 per 100 person-years in control individuals.

Adjusted analysis revealed a 10-percent (hazard ratio [HR], 1.10, 95 percent CI, 1.07–1.13; p<0.001) and 26-percent (HR, 1.26, 95 percent CI, 1.10_1.44; p<0.001) increased risk of developing depression in adults and paediatric patients with HS, respectively, as compared to controls.

Among those with HS, depression was associated with female sex, white race, smoking, and body mass index or obesity in both adults and paediatric patients and with substance abuse in adults only.

These findings support those of a recent systematic review and meta-analysis, which reported a high burden of depression and anxiety among patients with HS. The authors then urged clinicians to be vigilant for the presence of depression or anxiety and to refer patients when appropriate. [J Am Acad Dermatol 2020;83:542-553]

The current study was limited by the absence of patients not seeking care in health systems within the databases in the analysis.