Original articleAssociation between hidradenitis suppurativa, depression, anxiety, and suicidality: A systematic review and meta-analysis
Section snippets
Literature search
The following databases were searched for articles from the earliest entry in the respective databases up to May 9, 2018: MEDLINE, PubMed, EMBASE, Cochrane Library, Latin American and Caribbean Health Sciences (LILACS), Scopus, PsychInfo, and Global Resource for Eczema Trials (GREAT). Search strategies were modified from previous reviews of HS,8 anxiety,9 and depression and suicidal ideation10 (Supplemental Table I available via Mendeley at https://data.mendeley.com/datasets/bnj8znmdwp/1).
Literature search
Overall, 1036 nonduplicate citations were identified; 907 were excluded during title and abstract review, and 91 were excluded during full-text review. Thirty-eight observational studies met inclusion/exclusion criteria and were included in this systematic review, as outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram (Fig 1)11; 27 articles were included in the quantitative meta-analyses.
Study characteristics
All studies were published from 1963 through 2018.
Discussion
This systematic review and meta-analysis found that approximately 1 in 4 adults with HS had depression and that 1 in 5 had anxiety (summarized in Table I). Specifically, adults with HS had significantly higher odds of depression and anxiety, regardless of the study design, control population, and disease classification. Patients with HS had higher rates of antidepressant and anxiolytic medication use. HS was associated with increased depression and/or anxiety scores in some studies in the
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2022, Journal of Investigative DermatologyCitation Excerpt :Also associated with significant morbidity, HS is associated with increased mortality, in particular owing to cardiovascular events, with increased cancer risk also recorded (Egeberg et al., 2016; Jung et al., 2020). Depression, anxiety, and substance misuse are also common (Garg et al., 2018; Patel et al., 2020). The cause of HS is incompletely understood, with follicular occlusion; dysregulated inflammatory response of cytokines such as TNF-α, IL-1β, and IL-17; and an altered microbiota thought to play a role (Balato et al., 2019; Guet-Revillet et al., 2014; Kelly et al., 2015; Nikolakis et al., 2015; Ring et al., 2015; Sabat et al., 2020; von Laffert et al., 2010).
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Dr Patel and Mr Lee are cofirst authors.
Funding sources: None.
Conflicts of interest: None disclosed.
Accepted for publication November 22, 2019.
IRB approval status: Not applicable.
Reprints not available from the authors.