Zusammenfassung
Hintergrund
Die Befunde der vereinzelten durchgeführten Studien legen nahe, dass v. a. Depressionen und Angststörungen als häufigste psychiatrische Komorbiditäten bei Patienten mit einer Hidradenitis suppurativa/Acne inversa (HS/AI) vorkommen.
Methodik
Im Rahmen einer prospektiven Studie wurden 51 Patienten mit einer HS/AI hinsichtlich einer psychiatrischen Komorbidität mittels eines standardisierten Interviews und Fragebögen näher untersucht.
Ergebnisse
Bei der fachpsychiatrischen Untersuchung fand sich bei 29,4 % der HS/AI-Patienten eine zusätzliche psychische Symptomatik, die sich v. a. in Form einer depressiven Störung manifestierte. Die HS/AI-Patienten waren eher jung, eher Frauen und wiesen ein häufiges Vorkommen von Nikotin- und Alkoholkonsum und eine positive Familienanamnese für eine paternale Alkoholabhängigkeit auf. Darüber hinaus bestanden bei den HS/AI-Patienten deutlicher psychosoziale Einschränkungen in Form von fehlender Partnerschaft und eine durch die vorhandenen Symptome deutliche psychische Belastung.
Schlussfolgerung
Die Acne inversa ist eine schwere chronische entzündliche Hauterkrankung, die ähnlich wie andere inflammatorische Dermatosen mit psychischer Komorbidität und psychosozialen Beeinträchtigungen einhergeht. Da v. a. junge Patienten betroffenen sind, sollte frühzeitig eine psychiatrisch-psychotherapeutische Mitbehandlung erwogen werden.
Abstract
Background
The findings of most studies suggest that depression and anxiety disorders are the most common psychiatric comorbidities in patients with hidradenitis suppurativa/acne inversa (HS/AI).
Methods
In a prospective study, 51 patients with HS/AI were further examined for psychiatric comorbidity using a standardized interview and questionnaires.
Results
In psychiatric examination, 29.4% of HS/AI patients had additional mental symptoms, mainly manifested as depressive disorder. The HS/AI patients were rather young and female, and they showed a high incidence of nicotine and alcohol use, and a positive family history of paternal alcohol dependence. In addition, HS/AI patients experienced more severe psychosocial impairments in the form of lack of partnership and lower school attainment.
Conclusions
Acne inversa is a severe chronic inflammatory skin disease that, like other inflammatory dermatoses, is associated with mental comorbidity and psychosocial impairments. Since especially young patients are affected, a psychiatric–psychotherapeutic cotreatment should be considered already at an early stage.
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Literatur
- 1.
Ackenheil M, Stotz G, Dietz-Bauer R (1997) M.I.N.I. PLUS Version 4.5. LMU München, München
- 2.
Beck AR, Ward C, Mendelson M (1967) Beck Depression Inventory (BDI). Arch Gen Psychiatry 4:561–571
- 3.
Bielawski DM, Zaher FM, Svinarich DM, Abel EL (2002) Paternal alcohol exposure affects sperm cytosine methyltransferase messenger RNA levels. Alcohol Clin Exp Res 26(3):347–351
- 4.
Borkenau P, Ostendorf F (2008) NEO-FFI: NEO-Fünf-Faktoren-Inventar nach Costa und McCrae, Manual, 2. Aufl. Hogrefe, Göttingen
- 5.
Canoui-Poitrine F, Le Thuaut A, Revuz JE et al (2013) Identifikation of three hidradenitis suppurativa phenotypes: latent class analysis of a cross-sectional study. J Invest Dermatol 133:1506–1511. https://doi.org/10.1038/jid.2012.472
- 6.
Canoui-Poitrine F, Revuz JE, Wolkenstein P et al (2009) Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa with analysis of factors associated with disease severity. J Am Acad Dermatol 61:51–57. https://doi.org/10.1016/j.jaad.2009.02.013
- 7.
Cheng CM, Hsu JW, Huang KL et al (2015) Risk of developing major depressive disorder and anxiety disorders among adolescents and adults with atopic dermatitis: a nationwide longitudinal study. J Affect Disord 178:60–65. https://doi.org/10.1016/j.jad.2015.02.025
- 8.
Cosmatos I, Matcho A, Weinstein R et al (2013) Analysis of patient claims data to determine the prevalence of hidradenitis suppurativa in the United States. J Am Acad Dermatol 68(3):412–419. https://doi.org/10.1016/j.jaad.2012.07.027
- 9.
Deckers IE, van der Zee HH, Boer J, Prens EP (2015) Correlation of early-onset hidradenitis suppurativa with stronger genetic susceptibility and more widespread involvement. J Am Acad Dermatol 72(3):485–488. https://doi.org/10.1016/j.jaad.2014.11.017
- 10.
Farzanfar D, Dowlati Y, French LE, Lowes MA (2018) Inflammation: a contributor to depressive comorbidity in inflammatory skin disease. Skin Pharmacol Physiol 31:246–251. https://doi.org/10.1159/000490002
- 11.
Finergersh A, Rompala GR, Martin DIK et al (2015) Drinking beyond a lifetime: New and emerging insights into paternal alcohol exposure on subsequent generations. Alcohol 49(5):461–470. https://doi.org/10.1016/j.alcohol.2015.02.008
- 12.
Franke GH, Derogatis LR (2000) BSI-brief symptom inventrory manual. Beltz, Göttingen
- 13.
Garg A, Kirby JS, Lavian J et al (2017) Sex- and age-adjusted population analysis of prevalence estimates for hidradenitis suppurativa in the United States. JAMA 153(8):760–764. https://doi.org/10.1001/jamadermatol.2017.0201
- 14.
Garg A, Papagermanos V, Midura M et al (2018) Opioid, alcohol, and cannabis misuse among patients with hidradenitis suppurativa: a population-based analysis in the United States. J Am Acad Dermatol 79(3):495–500. https://doi.org/10.1016/j.jaad.2018.02.053
- 15.
Gooderham M, Papp K (2015) The psychosocial impact of hidradenitis suppurativa. J Am Acad Dermatol 73(5 Suppl 1):19–22. https://doi.org/10.1016/j.jaad.2015.07.054
- 16.
Gupta MA, Gupta AK (2003) Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol 4:833–842. https://doi.org/10.2165/00128071-200304120-00003
- 17.
Guy W (1976) 24 national institute of mental health: 12-CGI.clinical global impressions. In: Guy W, Bonato RR (Hrsg) Manual for the ECDEU assessment battery. Chevy Chase, Maryland, S 12-1–12.6
- 18.
Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296. https://doi.org/10.1111/j.2044-8260.1967.tb00530.x
- 19.
Hessam S, Gambichler T, Skrygan M et al (2018) Reduced ten-eleven translocation and isocitrate dehydrogenase expression in inflammatory hidradenitis suppurativa lesions. Eur J Dermatol 28(4):449–456. https://doi.org/10.1684/ejd.2018.3369
- 20.
Hessam S, Sand M, Georgas D et al (2016) Microbial profile and antimicrobial susceptibility of bacterial found in inflammatory hidradenitis suppurativa lesions. Skin Pharmacol Physiol 29:161–167. https://doi.org/10.1159/000446812
- 21.
Hessam S, Sand M, Lang K et al (2017) Altered global 5‑Hydroxymethylation status in Hidradenitis suppurativa: support for an epigenetic background. Dermatology 233:129–135. https://doi.org/10.1159/000478043
- 22.
Huilaja L, Tiri H, Jokelainen J et al (2018) Patients with Hidradenitis Suppurativa have a high psychiatric disease burden: a Finnisch nationwide registry study. J Investi Dermatol 138:46–51. https://doi.org/10.1016/j.jid.2017.06.020
- 23.
Jemec GB (2012) Clinical practice. Hidradenitis suppurativa. N Engl J Med 366(2):158–164. https://doi.org/10.1056/NEJMcp1014163
- 24.
Juckel G, Morosini PL (2008) The new approach: psychosocial functioning as a necessary outcome criterion for the therapeutic success in schizophrenia. Curr Opin Psychiatry 21:630–639. https://doi.org/10.1097/YCO.0b013e328314e144
- 25.
Karagiannidis I, Nikolakis G, Sabat R, Zouboulis CC (2016a) Hidradenitis suppurativa/Acne inversa: an endocrine skin disorder? Rev Endocr Metab Disord 17(3):335–341. https://doi.org/10.1007/s11154-016-9366-z
- 26.
Karagiannidis I, Nikolakis G, Zouboulis CC (2016b) Endocrinologic aspects of hidradenitis suppurativa. Dermatol Clin 34:45–49. https://doi.org/10.1016/j.det.2015.08.005
- 27.
Kirby JS, Butt M, Esmann S, Jemec GBE (2017) Association of resilience with depression and health-related quality of life for patients with hidradenitis suppurativa. JAMA Dermatol 153(12):1263–1269. https://doi.org/10.1001/jamadermatol.2017.3596
- 28.
Kurek A, Milena A, Peters J et al (2013) Depression is a frequent co-cormobidity in patients with acne inversa. J Dtsch Dermatol Ges 11(8):743–749, 743–750. https://doi.org/10.1111/ddg.12067
- 29.
Laux L, Glanzmann P, Schaffner P, Spielberger CD (1981) Das state-trait-angsinventar. Beltz, Weinheim
- 30.
Lee DE, Clark AK, Shi VY (2018) Hidradenitis suppurativa: disease burden and etiology in skin of color. Dermatology. https://doi.org/10.1159/000486741
- 31.
Lehrl S (1976) Der MWT – Ein Intelligenztest für die ärztliche Praxis. Neurol Psychiatr 7:488–491
- 32.
Liu M, Jiang Y, Wedow R et al (2019) Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use. Nat Genet 51(2):237–244. https://doi.org/10.1038/s41588-018-0307-5
- 33.
Matusiak L, Bieniek A, Szepietowski JC (2010) Psychophysical aspects of hidradenitis suppurativa. Acta Derm Venereol 90:264–268. https://doi.org/10.2340/00015555-0866
- 34.
Matusiak L (2018) Profound consequences of hidradenitis suppurativa: a review. Br J Dermatol. https://doi.org/10.1111/bjd16603
- 35.
Mavrogiorgou P, Akyol M, Siebers F et al (2015) Low psychosocial functioning in obsessive-compulsive disorder and its clinical implications. J Obsessive Compulsiv Relat Disord 5:87–92
- 36.
Meixner D, Schneider S, Krause M, Sterry W (2008) Acne inversa. J Dtsch Dermatol Ges 6(3):189–197. https://doi.org/10.1111/j.1610-0387.2007.06492.x
- 37.
Morosini PL, Magliano L, Brambilla L, Ugolini S, Pioli R (2000) Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatr Scand 101(4):323–329
- 38.
Nikolakis G, Join-Lambert O, Karagiannidis I et al (2015) Bacteriology of hidradenitis suppurativa/acne inversa: a review. J Am Acad Dermatol 73(5 Suppl 1):S12–S18. https://doi.org/10.1016/j.jaad.2015.07.041
- 39.
Onderdijik AJ, van der Zee HH, Esmann S et al (2013) Depression in patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 27:473–478. https://doi.org/10.1111/j.1468-3083.2012.04468.x
- 40.
Ouko LA, Shantikumar K, Knezovich J et al (2009) Effect of alcohol consumption on CpG methylation in the differentially methylated regions of H19 and IG-DMR in male gametes: implications for fetal alcohol spectrum disorders. Alcohol Clin Exp Res 33(9):1615–1627. https://doi.org/10.1111/j.1530-0277.2009.00993.x
- 41.
Patel KR, Rastogi S, Singam V et al (2019) Association between hidradenitis suppurativa and hospitalization for psychiatric disorders: a cross-sectional analysis of the national inpatient sample. Br J Dermatol 82(1):62–71. https://doi.org/10.1016/j.jaad.2019.05.102
- 42.
Patton JH, Stanford MS, Barratt E (1995) Factor structure of the Barratt impulsiveness scale. J Clin Psychol 51(6):768–774
- 43.
Sabat R, Tsaousi A, Rossbacher J et al (2017) Acne inversa/Hidradenitis suppurativa: Ein Update. Hautarzt 68(12):999–1006. https://doi.org/10.1007/s00105-017-4082-5
- 44.
Schaub D, Juckel G (2011) PSP Scale: German version of the Personal and Social Performance Scale: valid instrument for the assessment of psychosocial functioning in the treatment of schizophrenia. Nervenarzt 82(9):1178–1184. https://doi.org/10.1007/s00115-010-3204-4
- 45.
Shavit E, Dreiher J, Freud T et al (2015) Psychiatric comorbidities in 3207 patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 29(2):371–376. https://doi.org/10.1111/jdv.12567
- 46.
Shlyankevich J, Chen AJ, Kim GE, Kimball AB (2014) Hidradenitis suppurativa is a systematic disease with substantial comorbidity burden: a chart-verfied case-control analysis. J Am Acad Dermatol 71(6):1144–1150. https://doi.org/10.1016/j.jaad.2014.09.012
- 47.
Tay N, Macare C, Liu Y et al (2019) IMAGEN Consortium Allele-specific methylation of SPDEF: a novel moderator of psychosocial stress and substance abuse. Am J Psychiatry 176(2):146–155. https://doi.org/10.1176/appi.ajp.2018.17121360
- 48.
Thorlacius L, Cohen AD, Gislason GH et al (2018) Increased suicide risk in patients with hidradenitis suppurativa. J Invest Dermatol 138(1):52–57. https://doi.org/10.1016/j.jid.2017.09.008
- 49.
Tiri H, Jokelainen J, Timonen M, Tasanen K, Huilaja L (2018) Somatic and psychiatric comorbidities of hidradenitis suppurative in children and adolescents. J Am Acad Dermatol 79(3):514–519. https://doi.org/10.1016/j.jaad.2018.02.067
- 50.
Vazquez BG, Alikhan A, Weaver AL, Wetter DA, Davis MD (2013) Incidence of hidradenitis suppurativa and associated faktors: a population-based study of Olmsted county, Minnesota. J Invest Dermatol 133(1):97–103. https://doi.org/10.1038/jid.2012.255
- 51.
Wertenteil S, Strunk A, Garg A (2018) Association of low socioeconomic status with hidradenitis suppurativa in the United States. JAMA Dermatol 154(9):1086–1088. https://doi.org/10.1001/jamadermatol.2018.2117
- 52.
Wieting J, Rhein M, Hillemacher T et al (2019) DNA Methylation of the Leptin Gene Promoter is altered by chronic alcohol exposure in an animal model for alcohol dependence. Eur Addict Res 25(2):49–55. https://doi.org/10.1159/000496111
- 53.
Wiseman MC (2004) Hidradenitis suppurativa: a review. Dermatol Ther 17(1):50–54. https://doi.org/10.1111/j.1396-0296.2004.04007.x
- 54.
Zimmermann U, Spring K, Kunz-Ebrecht SR et al (2004) Effect of ethanol on hypothalamic-pituitary-adrenal system response to psychosocial stress in sons of alcohol-dependent fathers. Neuropsychopharmacology 29:1156–1165. https://doi.org/10.1038/sj.npp.1300395
- 55.
Zouboulis C, Bechara FG, Fritz K et al (2012) S1-Leitlinie zur Therapie der Hidradenitis suppurativa/Akne Inversa (ICD-10 Ziffer: L73.2). J Dtsch Dermatol Ges 10(Suppl 5):S1–S31. https://doi.org/10.1111/j.1610-0387.2012.08006.x
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P. Mavrogiorgou, G. Juckel, A. Reimelt, S. Hessam, L. Scholl, J.L. Frajkur, E. Stockfleth und F.G. Bechara geben an, dass kein Interessenkonflikt besteht.
Alle beschriebenen Untersuchungen am Menschen oder an menschlichem Gewebe wurden mit Zustimmung der zuständigen Ethikkommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.
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Mavrogiorgou, P., Juckel, G., Reimelt, A. et al. Psychiatrische Komorbidität bei Hidradenitis suppurativa/Acne inversa. Hautarzt (2021). https://doi.org/10.1007/s00105-020-04742-9
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Schlüsselwörter
- Psychische Störungen
- Depression
- Angststörungen
- Chronische entzündliche Hauterkrankung
- Psychosoziale Beeinträchtigung
Keywords
- Mental disorders
- Depression
- Anxiety disorders
- Chronic inflammatory diseases of the skin
- Psychosocial impairment