A systematic review and meta-analysis of psychiatric diseases in individuals with primary hyperhidrosis

Primary hyperhidrosis is associated with a substantial mental burden. In this study, the objective was to compare the occurrence of psychiatric diseases in individuals with and without primary hyperhidrosis by systematically reviewing the literature and conducting a meta-analysis. The PRISMA statement and the MOOSE checklist were employed. Cochrane Library, Embase and PubMed were searched. The risk of bias was determined by the Newcastle-Ottawa Scale. A random effects model was employed in the meta-analysis. Fifteen studies met the eligibility criteria, encompassing 50 429 participants with hyperhidrosis and 182 464 control participants. Hyperhidrosis was associated with increased odds of anxiety (odds ratio 3.5, 95% confidence interval 1.0-11.8) and depression (odds ratio 2.4, 95% confidence interval 1.4-4.0). Studies using outcome definitions for anxiety and depression and not included in the meta-analysis showed similar results. Studies reporting on other morbidities (i.e. body dysmorphic disorder, social phobia and stress) found a higher occurrence of these outcomes in the individuals with hyperhidrosis than in the control participants. Primary hyperhidrosis is associated with anxiety and depression. These results acknowledge the psychiatric burden that patients with primary hyperhidrosis experience.