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Psychiatric Comorbidities Present in 1 in 4 Patients With HS


Affective, anxiety, and neurotic disorders were among the most common in a recent study.

In a recent cross-sectional study1 exploring the burden of disease and clinical characteristics of hidradenitis suppurativa (HS), researchers found that psychiatric disease was comorbid in 27.4% of patients with HS, with affective, anxiety, and neurotic disorders being among the most common.

Kristina Blokhin/Adobe Stock
Kristina Blokhin/Adobe Stock

Citing the often high occurrence of comorbidities in patients with HS, researchers sought to examine the rates of psychological and psychiatric comorbidities in this patient population, given already high rates of psychiatric comorbidities in dermatologic conditions. This is compounded by impaired quality of life and body image among patients.

Key Takeaways

  • Psychiatric comorbidities affected 27.4% of individuals with HS in the study.
  • Affective disorders and anxiety/neurotic disorders are the most common psychiatric comorbidities among HS patients.
  • Some psychiatric comorbidities are associated with non-psychiatric comorbidities.

Researchers recruited patients (n=667) with HS who had been referred from a dermatology outpatient clinic between January 2016 to October 2022. Upon recruitment, researchers collected relevant demographic and clinical data through clinical examinations and patient interviews. Measurements for disease severity and well-being impacts included Hurley staging, number of lesions within the past month, International Hidradenitis Suppurativa Severity Score System (IHS4), Dermatology Life Quality Index (DLQI), Visual Analog Scale (VAS-10), and the International Classification of Disease 10th Revision (ICD-10).

Of all patients included in the study, 27.4% had at least one current, diagnosed psychiatric comorbidity. Of these, 16.2% had an affective disorder and 10.6% had anxiety or neurotic disorders. Approximately 5.8% of patients reported having 2 diagnosed psychiatric conditions, while 2.09% had been diagnosed with 3 or more conditions. Other psychiatric conditions represented by the patient cohort included schizophrenia or psychosis, ADHD or Tourette syndrome, personality disorders, eating disorders, autism, or other unspecific conditions.

These psychiatric comorbidities, in some cases, shared a link with non-psychiatric comorbidities, as well. For example, patients with psychiatric comorbidities were more likely to have comorbid asthma orchronic obstructive pulmonary disease; specific to schizophrenia as a comorbidity, patients with this diagnosis were more likely to have acne than those without psychiatric comorbidities. However, patients with comorbid psychiatric conditions were also less likely to experience IBD.

“This study showed a high prevalence of PCM [psychiatric comorbidity] in patients with HS and that patients with HS and concomitant PCM exhibit a variation in demographic and clinical characteristics, risk factors and burden of disease, which warrants an increased need for a multidisciplinary approach and awareness from the clinician,” wrote study authors Holgersen et al.


  1. Holgersen N, Nielsen VW, Ring HC, et al. Psychiatric co‐morbidity in patients with hidradenitis suppurativa: A cross‐sectional study of clinical characteristics and burden of disease. JEADV Clin Pract. Published online September 12, 2023. doi:10.1002/jvc2.222
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