A longitudinal study of stress and depression in patients with hidradenitis suppurativa

Summary: Abstract Body: Hidradenitis suppurativa (HS) is associated with significantly increased anxiety and depression. However, it remains unknown whether these psychosocial effects fluctuate with changes in HS disease activity. We aimed to characterize the association between psychosocial outcomes and disease activity in Hidradenitis Suppurativa in a prospective longitudinal cohort. Patients with HS were recruited from Stanford Healthcare Dermatology clinic between September 2023 and December 2024 (IRB 68654). Patients completed weekly questionnaires for up to 16 weeks, including self-reported measures of lesion count, pain, flare status, HS severity, medications, quality of life measures, stress, and anxiety. Psychosocial outcomes were assessed using the Patient Health Questionnaire 2 (PHQ-2) and Generalized Anxiety Disorder 2 (GAD-2) questionnaires. Ninety-four patients with HS were enrolled in the study (average age: 33 years, range: 18-68, 79.8% female, 16% male, and 4.3% non-reporting). A total of 951 surveys were completed, with 531 self-reporting a flare. 16% of the population reported a GAD-2 score > 3, indicating likely generalized anxiety disorder. 19% of the cohort reported a PHQ-2 score >3, indicating likely major depressive disorder. PHQ-2 scores were 1.44X greater in the flaring group compared to the non-flaring group (2.11 vs 1.47, p< 0.001). Similarly, GAD-2 scores were 1.58X greater in the flaring group compared to the non-flaring group (1.76 vs 1.11, p<0.001). These findings demonstrate a significant association between HS flares and worsened psychosocial outcomes, including anxiety and depression. This underscores the need for comprehensive management of HS flares to reduce the psychosocial impact in patients with HS. Acknowledgements: Study surveys were collected under a collaborative grant from UCB Pharma, Brussels, Belgium. We would like to thank Helena Andres-Terre, Tanja Tran, Ingrid Pansar, Matladi N. Ndlovu from UCB Pharma for their contributions to this study. Sahar Caravan¹, Victoria Harbour¹, Jeanie Ramos¹, James M. Kilgour¹, Kiana Yekrang¹, Lisa Zaba¹, Maria Aleshin¹, Kavita Sarin¹ 1. Dermatology, Stanford University School of Medicine, Stanford, CA, United States. Clinical Research: Epidemiology and Observational Research