Evaluation of the effect of sexual dysfunction, depression and anxiety on the quality of life in patients diagnosed with hydradenitis suppurativa

Hidradenitis suppurativa is a chronic and recurrent skin disease. This disease occurs in folded areas such as the armpits, groin, and under the breasts and is characterized by painful, inflamed nodules, abscesses, and fistulas. Treatment of this disease is difficult and limited, so it can have a significant impact on patient quality of life. The quality of life of patients with Hidradenitis suppurativa may be adversely affected by psychological effects such as sexual dysfunction, depression and anxiety. These effects can have many causes. First, pain may be experienced during sexual intercourse due to painful lesions and the sensation of pain, which can lead to sexual dysfunction. Depression and anxiety are other psychological factors that negatively affect the quality of life of patients with hidradenitis suppurativa. The symptoms of the disease may limit the social life and daily activities of the patients, which may lead to the development of depression and anxiety. The aim of this study is to investigate the prevalence of sexual desire and dysfunction in patients with HS and its relationship with quality of life, anxiety, depression, psychological distress and clinical features. A total of 120 individuals, including 60 patients (patient group) and 60 healthy individuals (control group), diagnosed with hidradenitis suppurativa were included in the study. To all participants; Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Arizona Sexual Experiences Inventory (ASEX), Female Sexual Function Inventory (FSFI)/International Erectile Function Index (IIEF) scales were applied. Scale scores of the patient and control groups were compared. In the patient group, the relationship between the scale scores and the severity and extent of the disease and the sites of involvement was evaluated. The relationship between depression, anxiety and sexual dysfunction in the patients and the control group was evaluated. IBM SPSS 21 and MedCalc statistical package program were used to evaluate the data. Forty (66.6%) of the patients included in the study were male and 20 (33.3%) were female. The mean age of the patients (n:60) was 35.1±11.9 years and the age of onset of the disease was 25.9±10. for 2 years. The age range with the highest rate of patients (36.7%) was 20-29. 61.7% of the patients state that they smoke. While the mean body mass index of the patients was 27.91±5.16, 33.3% of the patients were obese and 38.3% were overweight. Patients were predominantly accompanied by DM in 21.7%, HT in 23.3%, dyslipidemia in 15%, and CVD in 10%. Among the genders; The difference between the smoking pkt/day averages was significant (p<;0.05). When the patients included in the study were examined according to the distribution of HS locations, it was found that the most common inguinal (70%), axilla (66.7%), pubis (53.3%) and then the inner thigh (50%) and hip (51%) involvement were found. According to Hurley classification, 36.7% (n=22) of the patients in our study group were stage 2, 35% (n=21) were stage 1 and 28.3% (n=17) were stage 3. There is a positive, high-grade (r=0.90) significant relationship between Hurley Stage and Modified Sartorius (p<0.05). A positive, moderate (r=0.50) significant relationship between Hurley Stage and DYKI of the patients in question (p<0.05). There was a positive, high-grade (r=0.91) significant correlation between the patients; Hurley Stage and the Physician;s Global Assessment (p<0.05). The difference between DYKI, Beck Depression Inventory, Beck Anxiety Inventory and ASEX total score averages was significant between the patient and control groups (p<0.05). Among female patient and control groups; while the difference between the mean scores of the DYKI, Beck Depression Scale, Beck Anxiety Scale scores was significant (p<0.05), there was no significant difference between the mean scores of the FSFI and ASEX scores (p>0.05). While the difference between the mean scores of DYKI, Beck Depression Scale, Beck Anxiety Scale and ASEX scale scores was significant (p<0.05), no significant difference was found between the mean scores of IIEF and IIEF-Erectile Dysfunction scale scores (p>0.05) When the DYKI, BDI, BAI, ASEX scales, modified Sartorius score and Hurley staging were examined among the patient groups; There was no statistically significant difference between the total mean scores of the DYKI, Beck Depression Inventory, Beck Anxiety Scale, ASEX and Modified Sartorius Score. (p>0.05) There is a significant positive correlation between Hurley Stage and disease duration, DYKI, BDI and BAI scales.(p<0.05). There is a significant negative correlation between Hurley Stage and IIEF (p<0.05). No significant relationship was found between Hurley Stage and FSFI. In patients with genital area involvement; While the mean scores of DYKI, Beck Depression Inventory, Beck Anxiety Inventory, ASEX and IIEF scales were statistically different than those without involvement (p<0.05); No statistically significant difference was found between the FSFI scale mean scores (p>0.05). The number of affected areas and the severity of the disease (Modified Sartorius score) were found to have a significant effect on the DYKI of the patients (p<0.05). The effects of patient age, disease duration, disease onset age, and smoking amount pkt/day averages on DYKI were not statistically significant (p>0.05). A significant correlation was found between DYKI and Physician Global Assessment, hurley stage and presence of pilonidal sinus. (p<0.05) In our study, there was a significant difference in DYKI, BDI, BAI, ASEX and IIEF scores in patients with genital area involvement compared with patients without genital area involvement (p<0.05). In the FSFI score; when patients with genital area involvement and patients without genital area involvement were compared, no significant difference was found.(p=0.97) As a result, we show that HS has a great impact on sexual health and quality of life. In addition, our study shows the importance of considering comorbid psychiatric diseases in patients with HS, evaluating the psychosocial status of the patient and referring them to psychiatry when necessary. Therefore, it is important to monitor the psychological health status of these patients and to offer appropriate treatment options to increase their quality of life. It may also be beneficial for patients to participate in support groups to help improve their psychological well-being. Key words: Anxiety, Depression, Hidradenitis, Quality of life, Sexuality