The prevalence and odds of anxiety and depression in children and adults with hidradenitis suppurativa: Systematic review and meta-analysis

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder. Previous studies have yielded divergent results on the prevalence of depression and anxiety in patients with HS. Objective: The aim of this meta-analysis was to provide a pooled estimate of the prevalence and odds of depression/anxiety in patients with HS. Methods: Search for and extraction of relevant literature without restrictions from 5 databases (Cochrane Database, EMBASE, PubMed, PsycINFO, Science Direct) were performed. Pooled meta-analyses were made by using random-effects models. Results: Meta-analyses of 28 studies of depression in HS and 12 of anxiety showed a prevalence of 21% (95% CI [17-25]) of depression and 12% (95% CI [6-17]) of anxiety in patients with HS, with very wide variations in both cases. Analysis of case-control studies showed an association between depression and HS (odds ratio, 1.99 95% CI [1.63-2.43]) and between anxiety and HS (odds ratio, 1.97 95% CI [1.65-2.35]). Limitations: The results of this meta-analysis are conditioned by the limitations of the studies included and by differences in patient populations, methodologic approach, and data available. Conclusion: Patients with HS have a high burden of depression and anxiety. Our results show that clinicians need to be vigilant for the presence of depression or anxiety and to refer patients when appropriate.