New-onset depression among children, adolescents, and adults with hidradenitis suppurativa

Background: Information on the risk of depression among children, adolescents, and adults with hidradenitis suppurativa (HS) is limited. Objective: To compare the risk of new-onset depression in patients with HS with that of control individuals. Methods: Retrospective cohort analysis of 49,280 adult and 3042 pediatric patients with HS and matched control individuals identified by using electronic health record data. The primary outcome was incident depression. Results: The crude incidence rate was 4.8 per 100 person-years in adult patients with HS compared to 3.0 per 100 person-years in control individuals. Among pediatric patients, the crude incidence rate was 4.2 per 100 person-years in patients with HS compared with 2.3 per 100 person-years in control individuals. In adjusted analysis, adults and pediatric patients with HS had a 10% (hazard ratio, 1.10; 95% confidence interval, 1.07-1.13; P<.001) and 26% (hazard ratio, 1.26; 95% confidence interval, 1.10-1.44; P<.001), respectively, increased risk of developing depression compared to control individuals. Among patients with HS, factors associated with depression included female sex, white race, smoking, and body mass index/obesity in adults and pediatric patients and substance abuse in adults only. Limitations: Patients not seeking care in health systems within the database were not captured. Conclusion: Children, adolescents, and adults with HS are at an increased risk for developing depression, independent of other common risk factors for depression.