Aims: Hidradenitis Suppurativa‐Acne Inversa (HS) is one of the most debilitating chronic skin diseases and has a substantial adverse impact on emotional and relational life of the patients. The main goal of this cross‐sectional study is to investigate the psychological and emotional impact of this disease, with a specific focus on psychiatric symptoms, particulary depression, on suicidal ideation, self‐esteem, anger and some personality traits, in a population of HS patients. Methods: 38 subjects (22 F, 16 M) with diagnosis of HS (HS Group), aged over 15, without previous major psychiatric disorders, not in treatment with psychotropic drugs and isotretinoin, were recruited and compared with an age‐ and gender‐matched control group of 28 outpatients with nevi (15 F, 13 M), referring to the Dermatology Unit for a consultation (N Group). Psychometric assessment was carried out using the following rating scales: GHQ‐28 (General Health Questionnaire), a screening tool designed to detect the presence of psychiatric disorders (cut‐off score ≥5 to identify “casenesses”), which measures somatic symptoms, anxiety and insomnia, social dysfunction and severe depression. STAXI‐2 (Stait‐Trait Anger Expression Inventory), to explore anger in its different components: State and Trait Anger, Anger Expression and Anger Control. BDI‐II (Beck Depression Inventory II), for detecting depressive symptoms (cut‐off score ≥14 to identify a clinically significant depression). BHS (Beck Hopelessness Scale), for measuring suicidal ideation (cut‐off score >9 to detect suicidal risk). RSES (Rosenberg Self‐Esteem Scale), for assessing global self‐esteem (cut‐off score <15 to reveal a level of self‐esteem lower than the average). F.E. Questionnaire (Emotional Fragility), which provides a measure of personal inadequacy feelings experienced by the subject. I‐R Questionnaire (Irritability and Dissipation‐Rumination), for evaluating some personality traits indicators of aggression. Results: The comparison between HS Group and N Group for the psychometric variables (Mann‐Whitney U test) shows significant differences, with higher values in the HS Group for the following scales: GHQ‐28 (P=0.002); Somatic Symptoms (P=0.003); Anxiety and Insomnia (P=0.006); State Anger (P=0.0003); RSES (P=0.037); BDI‐II (P=0.006) and FE (P=0.013). The comparison between the two groups considering the cut‐off points in GHQ‐28, BDI‐II, BHS and RSES (Fisher′s exact test) shows a statistically significant difference for GHQ‐28 values, with scores in HS Group higher than in N Group (P=0.004). Conclusions: This study shows the evidence of a significant psychiatric comorbidity in HS patients and of a strong emotional impact of the disease: psychiatric symptoms, including depression, somatic symptoms, anxiety and insomnia, are higher than among matched controls, and state anger, emotional fragility and low self esteem are important psychological correlates in these patients.
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