PATIENTS with hidradenitis suppurativa (HS) were found to have a significantly higher risk of developing new-onset depression and anxiety, according to a large-scale Danish population-based cohort study. However, the findings did not support a consistent link between mental health outcomes and disease severity.
The study, conducted between 1997–2022, compared over 10,000 individuals diagnosed with hospital-confirmed HS to more than 40,000 matched individuals from the general population. Researchers found that patients with HS were 69% more likely to develop new-onset depression and 48% more likely to develop anxiety than those without the condition.
HS is a chronic inflammatory skin condition marked by painful nodules, abscesses, and sinus tracts, often recurring in areas of friction. The disease’s physical symptoms are known to impact patients’ quality of life, but its psychological burden remains under-recognised.
To evaluate the influence of disease severity on mental health outcomes, the study used treatment type and the number of hospitalisations for HS-related surgeries as markers. Despite this stratification, hazard ratios remained elevated across all treatment groups and hospitalisation levels, with no clear pattern suggesting a higher mental health risk for patients with more severe disease.
The study also found that patients with HS were more likely to have a history of depression (7.0% versus 0.3%) and anxiety (5.9% versus 0.5%) prior to the study period. However, the risk of recurrent depression or anxiety did not significantly differ between patients with HS and the control group.
“These findings suggest that patients with HS had an elevated risk of new-onset depression and anxiety,” the authors concluded. “Using treatment- and HS-related surgical procedures as severity markers, no consistent differences in mental health risk across severity levels were observed, emphasising the need for psychiatric assessment and intervention across all patients with HS, regardless of disease severity.”
While the study was strengthened by its long-term data and national coverage, limitations include its reliance on hospital-based diagnosis and the potential underrepresentation of milder HS cases.
These results underscore the importance of routine mental health screening and support for individuals with HS, regardless of how severe their disease appears clinically.
Reference
Holgersen N et al. Risk of new-onset and recurrent depression and anxiety among patients with hidradenitis suppurativa. JAMA Dermatol. 2025:e252298.
