The association between hidradenitis suppurativa and psychiatric disease: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Hidradenitis suppurativa (HS) has been associated with increased risk of psychiatric disease (PD) in patients with HS compared with the general population. To our knowledge, no recent comprehensive examination of the prevalence and association between HS and PD has been undertaken. OBJECTIVES: To investigate the association between HS and PD. METHODS: A systematic review and meta-analysis was performed using standard methodologies and was reported in accordance with the PRISMA guidelines. The medical databases PubMed, Embase, PsycINFO, Cochrane, Web of Science and the Directory of Open Access Journals were searched. Studies were included if addressing HS and any PD. Study quality was assessed through the Newcastle-Ottawa Scale (NOS). Certainty of evidence was assessed using the GRADE approach. RESULTS: A total of 83 studies were included in the narrative analysis of which 76 were included in the quantitative analysis. This study found that patients with HS had higher risk of depression, pooled prevalence 20.9% vs. 8.4%, odds ratio (OR) 2.06 [95% confidence interval (CI) 1.75-2.41], P < 0.001; anxiety, 19.3% vs. 8.1%, OR 1.91 (95% CI 1.64-2.22), P < 0.001; bipolar disorder, 1.0% vs. 0.06%, OR 3.68 (95% CI 1.11-12.20), P = 0.03; schizophrenia, 2.7% vs. 1.2%, OR 2.00 (95% CI 1.21-3.30), P = 0.007; substance use disorder 6.0% vs. 3.1%, OR 3.58 (95% CI 2.01-6.37), P < 0.001; alcohol abuse 4.0% vs. 1.8%, OR 1.88 (95% CI 0.98-3.58), P = 0.06, and completed suicide 0.7% vs. 0.4%, OR 1.56 (95% CI 1.14-2.14), P = 0.005 when compared with the general population. PD was more prevalent in female patients with HS (28.0%, 95% CI 22.5-34.3) compared with males (21.1%, 95% CI 15.6-27.9). Depression increased with increasing Hurley stage [stage I, 19.5% (95% CI 8.3-39.4); stage II, 20.9% (95% CI 11.5-34.9) and stage III, 35.3% (95% CI 16.1-60.8), P < 0.001]. North American studies had higher pooled prevalence of PD compared with European studies [35.4% (95% CI 13.6-65.6) vs. 21.2% (95% CI 11.9-34.7)]. Adults had higher pooled prevalence of depression compared with children [19.1% (95% CI 12.4-28.3) vs. 9.5% (95% CI 6.3-14.1)]. Half of included studies were assessed as high quality (NOS ≥ 7). CONCLUSIONS: This study found a significantly higher risk of several PDs in patients with HS compared with the general population. Our findings reflect a need to raise awareness of psychiatric illnesses in patients with HS to improve patients' quality of life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.036 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".