Hyperhidrosis Associated with Higher Anxiety, Depression, ADD

Dee Anna Glaser, MD, FAAD

Patients with primary hyperhidrosis—a condition that causes excessive sweating—are significantly more likely to experience anxiety, depression, and attention deficit disorder (ADD), according to new research presented at the 2019 Annual Meeting of the American Academy of Dermatology (AAD) in Washington, DC.

The mental health challenges her patients reported prompted this study said investigator Dee Anna Glaser, MD, FAAD, professor, interim chair, and director of clinical research and aesthetic and laser surgery in the department of dermatology at St. Louis University School of Medicine, St. Louis, Missouri.

“Many of them had either anxiety or depression,” Glaser said of her patients with hyperhidrosis. “There were some who had said they had suicidal thoughts because their sweating was ruining their life.”

The study included 500 patients diagnosed with primary hyperhidrosis between 2011 and 2018. The mean age of hyperhidrosis onset was 15 years, while the mean age at time of evaluation was 30 years. The majority (71.2%) of patients were female and most patients (61.4%) had 1 to 3 body locations affected by the condition. About a quarter (24.8%) had 4 to 6 sites affected and 13.8% had 7 to 9 sites affected.

The investigators considered participants to have anxiety, depression, or ADD if: the condition was self-reported on intake form, the patient had an ICD9 code of diagnosis, there was a clinical note documenting diagnosis, or if the patient was taking an ADD-specific medication.

Of these participants, 13.8% had a diagnosis of anxiety, 12.4% had depression, and 6.4% had ADD, all of which are statistically significantly higher than the general population, according to the authors.

While there was no observed association between hyperhidrosis severity or location with the likelihood of anxiety, depression, or ADD, there was a correlation between the number of hyperhidrosis locations and the prevalence of psychiatric comorbidities.

For patients with 1 to 3 sites affected by hyperhidrosis, the prevalence of anxiety and depression were about 9% for each condition. For patients with 7 to 9 sites, the rates of anxiety and depression were about 28% and 29%, respectively.

The most surprising association in the results was the connection between hyperhidrosis and attention deficit disorder said Glaser.

“I honestly don’t know what to make of it,” Glaser said in a statement. “I think we need to look into that more and connect with individuals who have experience with ADD and together understand what that link may be.”

Glaser stressed that health care providers need to be aware of the correlation between hyperhidrosis and anxiety, depression, and ADD.

“We need to proactively ask our patients with hyperhidrosis if they suffer with or have symptoms of anxiety, depression or ADD,” she said. “We can let them know that’s pretty common and help them find care from the appropriate professionals.”

The poster, “Prevalence of Anxiety, Depression and Attention Deficit Disorder (ADD) in Patients with Primary Hyperhidrosis,” was presented at the AAD Annual Meeting on Saturday, March 2, 2019.