New-onset Bipolar Disorder in Hidradenitis Suppurativa Patients: A Multi-center, Propensity-score-matched Cohort Study.

BACKGROUND/AIM: Hidradenitis suppurativa (HS) may be linked to an elevated risk of bipolar disorder, though the precise mechanism remains unclear. This study investigated the likelihood of bipolar disorder in patients with HS.

PATIENTS AND METHODS

We analyzed the electronic health records of 60,850 patients with HS and 60,850 matched controls from the TriNetX network, excluding those with a prior bipolar disorder diagnosis. Propensity score matching was conducted (1:1 ratio), and hazard ratios (HRs) were calculated to assess the risk of new-onset bipolar disorder in patients with HS compared to controls.

RESULTS

After matching, the HR for developing bipolar disorder in patients with HS was 1.549 [95% confidence interval (CI)=1.270-1.889] after a 1-year follow-up, remaining significant in 3- and 5-year follow-ups and sensitivity analyses. Stratified by sex, female patients with HS showed a notably higher risk (HR=1.509, 95%CI=1.353-1.683), while no significant increase was seen in males.

CONCLUSION

Patients with HS have a significantly elevated risk of developing bipolar disorder, especially among females. Healthcare providers should be mindful of this association when treating patients with HS.