Alexithymia, Psychological Distress, and Social Impairment in Patients with Hidradenitis Suppurativa

Abstract

Background: Hidradenitis suppurativa (HS) is a rare, chronic, inflammatory skin disease characterized by deep-seated nodules, abscesses, and draining fistulas. HS has a substantial adverse impact on patients’ lives. Only a few studies investigated the relationship between health-related quality of life, psychological distress, and emotional dysregulation in patients with HS. Alexithymia, namely the difficulty in describing or recognizing emotions, has been associated with various psychological disorders, such as anxiety, depression, and psychological distress. Objective: The aim of this study was to examine the prevalence of alexithymia in patients with HS and its association with demographic and clinical variables, quality of life indices, and psychological distress. Methods: Ninety outpatients with HS completed the 20-item Toronto Alexithymia Scale, the 12-item General Health Questionnaire (GHQ-12), the Dermatology Life Quality Index, the Skindex-17, and the 36-Item Short-Form Health Survey. Information on sociodemographic and clinical variables was retrieved from clinical records. Results: Alexithymia or borderline alexithymia was observed in 44.4% of patients with HS, with a higher prevalence of the alexithymic trait in women than in men (51.7 vs. 31.2%). We did not find any association between alexithymia and clinical variables. Of the entire sample analyzed, 46.1% reported high psychological distress; among them, 78% reported alexithymia or borderline alexithymia compared to 16.7% among GHQ noncases. Furthermore, HS patients with alexithymia or borderline alexithymia showed significantly higher scores on the Skindex-17 psychosocial scale and the Dermatology Life Quality Index, and a lower score on the mental component of the 36-item Short-Form Health Survey, than nonalexithymic patients. Conclusions: Dermatologists should consider alexithymia in the diagnosis and treatment of HS patients, given its important role in psychological and psychosocial distress.

Quality of Life in Hidradenitis Suppurativa: An Update

“…HRQoL impairment was associated with specific comorbidities, such as obesity and back pain, but not with having a family history of HS [ 77 ]. HS patients with alexithymia or borderline alexithymia when compared to non-alexithymic patients had significantly higher scores on the Skindex-17 psychosocial scale and the DLQI, and a lower score on the mental component of the SF-36 [ 78 ]. In HS patients with depression, disease severity as measured by the IHS4, and QoL measured by Skindex-17 and DLQI and SF-36 were significantly worse compared to HS patients with no depression [ 79 ].…”

Hidradenitis Suppurativa From a Patient Perspective Including Symptoms and Self-Treatment

“…27,28 Of note, other psychiatric conditions such as anxiety, bipolar disorder, psychosis, schizophrenia, and alexithymia have also been shown to be higher in HS patients than healthy counterparts. 9,[25][26][27] Given the high rates of psychiatric comorbidity seen in HS patients, early recognition and referral to psychiatry specialists have been recommended. However, with fast paced dermatology clinics, efficient strategies for psychological screening are still warranted.…”

“…Higher levels of loneliness, alexithyma, andemotional fragility have been linked to patients with HS. 8 -10 When compared to psoriasis, HS patients have significantly lower QoL and higher levels of anxiety and depression. 11…”

Personality and Cognitive–Emotional Variables in Spanish Children and Adolescents With and Without Cleft Lip and/or Palate

“…The presence of higher alexithymia scores has been associated with negative affect (Kessler et al, 2006) and somatization problems, with a positive correlations having been found between tension-type headaches and alexithymia in children and adolescents (Endler, 2002). The presence of alexithymia has been associated with symptoms of depression, anxiety, and low self-esteem, and impacting emotional regulation and increasing levels of psychological stress (Ghiggia et al, 2017;Quinto et al, 2019), variables that have been found among samples with CL/P in other studies (Fadeyibi et al, 2012;Piombino et al, 2014;De Oliveira et al, 2015). Measuring levels of alexithymia in these patients would help to identify and modify negative emotions before they have a clinical impact, especially considering that higher scores of this variable, such as those found in this study, are associated to the possible presence of symptoms of anxiety and depression.…”