Hyperhidrosis Prevalence,Demographical Characteristics And Its Relation With Anxiety And Depression

Background: Part 1: The reported prevalence of primary hyperhidrosis was varied in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence.Part 2: There are conflicting data about the correlation of hyperhidrosis and stress symptoms.Objectives: Part 1: This study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations.Part 2: We sought to compare the prevalence of anxiety and depression in hyperhidrosis and non-hyperhidrosis patients.Methods: In total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. Meanwhile, GAD-7 and PHQ-9 scales which were included in the same questionnaire were used for anxiety and depression assessments. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence and to evaluate the effects of demograghic variables on the prevalence anxiety and depression in patients with or without hyperhidrosis.Results: Part 1: The prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much of influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of hyperhidrosis between Chinese subjects in Shanghai and Vancouver.Part 2: The prevalence of anxiety and depression was 21.3% and 27.2% in hyperhidrosis patients, respectively, and 7.5% and 9.7% in patients without hyperhidrosis, respectively(P-value<0.001)There were positive correlations between hyperhidrosis severity and the prevalence of anxiety and depression. Limitations: The data were gathered according to patients’ self-reports only and the sample size was relatively small in some groups after stratification for, gender, ethnicity and age.Conclusion: Part 1: Prevalence of primary HH and late-onset HH is similar in dermatology outpatients independent of geographical locations. However, certain specific HH subtypes can show great variations according to ethnicity, age, body mass index and sex.Part 2: Both single-variant and multivariate analysis, showed that anxiety and depression were more prevalent in patients with, than without, hyperhidrosis.