Psychiatric morbidity and anger in patients with hidradenitis suppurativa - acne inversa and the impact on quality of life of caregivers

Scientific research question: Hidradenitis Suppurativa – Acne Inversa (HS-AI) is one of the mostdebilitating chronic skin diseases. It seriously affects the emotional and relational life of the patients, ithas a significant psychiatric comorbidity and it impairs the quality of life of both patients andcaregivers. The main goals of this study are: (i) to highlight the prevalence of psychiatric symptoms ina sample of patients affected by HS-AI, (ii) to explore the emotion of anger in these subjects, (iii) toevaluate the impact of HS on quality of life of their caregivers. Methodology: 37 subjects (17F; 15M) affected with HS-AI, aged over 15, with no previous majorpsychiatric disorders, not in treatment with psychotropic drugs and/or isotretinoin, were recruited inthis study.The clinical assessment has included age of onset, disease duration and its severity at the time ofevaluation (Sartorius Index). The psychometric assessment included the following rating scales: GHQ-28 (General Health Questionnaire), designed to measure somatic symptoms, anxiety and insomnia,social dysfunction and severe depression; STAXI-2 (Stait-Trait Anger Expression Inventory), to exploreanger in its different domains (experience, expression and control); FDLQI (Family Dermatology LifeQuality Index), to assess the impact of the disease on quality of life of the main caregiver. Findings:28.1% of the patients should be regarded as ‘psychiatric cases’ (with GHQ-28 cut-off ≥5).Young females (aged 20–29) show the highest scores in most of the different subscales of STAXI-2.Severity of HS-AI correlates positively with the Expression of Anger Inside (E/R In), while duration ofHS-AI correlates negatively with Anger Reaction (RT/R).Age of onset of HS-AI correlates positively with depressive symptoms in females.The severity of depression of the patient correlates positively with the impairment of quality of life ofthe caregiver. Conclusion: This study shows the evidence of a clinically relevant psychiatric morbidity in patientsaffectd by HS-AI. Anger is an important emotional component in these patients, especially in youngfemales. Depression of the patient seems to be the factor that most affects the quality of life of themain caregiver