Increased Suicide Risk in Patients with Hidradenitis Suppurativa

Abstract

Patients with skin disorders are considered at a higher risk of depression and anxiety than the background population. Patients with hidradenitis suppurativa (HS) may be particularly affected. We explored the association between HS and depression, anxiety, and completed suicides in the Danish national registries, expanding to include data on suicidal behavior, using both a cross-sectional and a cohort study design. Both designs included 7,732 patients with HS and a background population of 4,354,137. The cohort study revealed that HS patients had an increased risk of completed suicide after adjustment for confounding factors (11 per 7,732 vs. 2,904 per 4,354,137) (hazard ratio [95% confidence interval] = 2.42 [1.07-5.45]; P = 0.0334) and an increased risk of antidepressant drug use (1.30 [1.17-1.45]; P < 0.0001). In contrast to previous studies, the cross-sectional baseline data revealed nonsignificant association with depression (odds ratio [95% confidence interval] = 1.13; 0.87-1.47]; P = 0.36 and hospitalization due to depression (1.32 [0.94-1.85]; P = 0.1083). To the best of our knowledge, no previous studies have reported on the increased risk of completed suicide among HS patients. The increased risk of completed suicide is not solely explained by lifestyle and demographic differences and the results highlight the profound impact HS has on the lives of patients with this often devastating disease.

Development of HiSQOL: A Hidradenitis Suppurativa-Specific Quality of Life Instrument

“…Furthermore, patients with HS report of emotional reactions such as sadness, anger, irritation, and loss of control, and all in all, HS may greatly affect physical, psychological, and social QOL dimensions [5-11]. Notably, HS patients are at a greater risk of completed suicide than the background population [12], and although no causality has been established, this fact does emphasise the potentially profound consequences of HS.…”

Prevalence of patients with self‐reported hidradenitis suppurativa in a cohort of Danish blood donors: a cross‐sectional study

“…The male to female ratio is approximately 1 : 3 . HS is an impactful skin disease associated with psychological comorbidities, such as depression, anxiety, low quality of life, decreased utility, fatigue and suicide . In addition, patients with HS have been shown to have a lower socioeconomic status and a higher rate of unemployment than the background population …”

Hidradenitis suppurativa and schizophrenia: a nationwide cohort study

“…As medical management is shifting towards the development of assessments aimed at providing early detection and intervention, the results of the current study emphasize the importance of integrating a broader assessment to detect and account for both dermatological and psychological factors that might affect medical care. This assessment is especially crucial when considering the higher prevalence of attempted suicide in both schizophrenia and HS patients, as well as the importance of early treatment in both HS and schizophrenia, which might dramatically affect treatment options and outcomes.…”