Depressive Symptoms Decreased When Using Treatment Methods Increasing Resilience for Hidradenitis Suppurativa

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Patient-rated HS severity and depression score both independently estimated variation in HRQOL.
Patient-rated HS severity and depression score both independently estimated variation in HRQOL.

In the management and treatment of patients with hidradenitis suppurativa (HS), the use of methods that increase resilience may help decrease depressive symptoms and thus improve health-related quality of life (HRQOL), according to the results of a recent cross-sectional, multicenter study published in JAMA Dermatology.

A total of 154 patients ≥18 years of age (mean, 40.93±13.5 years; 84.4% women; 90.2% self-identified as white) from two referral centers in the United States and Denmark were surveyed between June 1, 2016 and March 31, 2017. The survey included 4 questionnaires: (1) a sociodemographic and clinical characteristics questionnaire; (2) the Brief Resilient Coping Scale; (3) the Hospital Anxiety and Depression Scale; and (4) the Dermatology Life Quality Index (DLQI). The primary outcome was HRQOL, as assessed by the DLQI.

Overall, 35.7% (55 of 154) of the patients were classified as having depression and 20.8% (32 of 154) reported having borderline depressive symptoms. Patient-rated HS severity and depression score both independently estimated variation in HRQOL, at 27% and 10%, respectively.

For the mediation analysis, resilience score was significantly associated with depressive symptoms score (P <.001). In addition, depressive symptoms score was significantly associated with lower HRQOL (P <.001). Both the direct and indirect association of resilience with HRQOL, however, were not statistically significant (P =.86 and P =.87, respectively), with these findings demonstrating that resilience did not mediate the association between depressive symptoms and HRQOL.

The investigators concluded that patients with HS who had higher resilience levels experienced smaller decreases in HRQOL as depressive symptoms increased. Because resilience can be taught, the opportunity exists to develop resiliency training programs and to explore their role in mitigating stress levels and depressive symptoms in patients with HS.

Reference                                                                                                                           

Kirby JS, Butt M, Esmann S, Jemec GBE. Association of resilience with depression and health-related quality of life for patients with hidradenitis suppurativa [published online November 8, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.3596

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