The Psychiatric Burden of Hidradenitis Suppurativa: A TriNetX Analysis of Sex-Specific Disparities in Mental Health and Medication Use

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition associated with physical and psychological burden. Prior research has shown increased rates of depression and anxiety among individuals with HS; however, sex-based disparities in the prevalence of these mental health conditions in patients with HS remain underexplored. Objective: To evaluate sex-based differences in the prevalence of major depressive disorder (MDD), generalized anxiety disorder (GAD), and the prescribing of antidepressants and anxiolytics among patients with HS. Methods: Using the TriNetX database, we identified patients over the age of 18 who had a recorded diagnosis of HS. Propensity score matching based on demographics was applied to compare prevalence rates of MDD, GAD, and antidepressant and anxiolytic prescriptions between patients with HS and matched controls without HS, as well as between men and women with HS. Results: Women with HS had significantly higher odds of MDD (OR: 1.40), GAD (OR: 1.22), and prescriptions for antidepressants (OR: 1.28) and anxiolytics (OR: 1.40) compared with women without HS. Men with HS demonstrated higher rates of MDD (OR: 1.33), GAD (OR: 1.13), and prescriptions for antidepressants (OR: 1.28) and anxiolytics (OR: 1.42) compared to men without HS. When comparing women with HS to men with HS, women had significantly higher odds of MDD (OR: 1.88), GAD (OR: 1.94), and prescriptions for antidepressants (OR: 1.72) and anxiolytics (OR: 1.39). Conclusion: A higher prevalence of psychiatric conditions was found in patients with HS compared to patients without HS, as well as in women with HS compared to men with HS. Recognizing these disparities is important, as they highlight the distinct psychological burdens experienced by women and men with HS that may influence disease management, treatment engagement, and overall quality of life.