Endoscopic thoracic sympathectomy for primary focal hyperhidrosis: impact on psycho-social symptomatology and psychotropic medication use

Li, Dan C.; Hulbert, Alicia; Waldbaum, Benjamin; Ober, Cecily; Hooker, Craig M.; Huang, Peng; Molena, Daniela; Yang, Stephen C.; Ito, Tomoaki; Perry-Parrish, Carisa; Brock, Malcolm V.

doi:10.1093/ejcts/ezy211

Cited by 17 publications

(12 citation statements)

References 31 publications

(33 reference statements)

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“…We also have noted that primary hyperhidrosis can have a significant psychologic impact on patients, and when effectively ameliorated, feelings of somatic anxiety subside. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

Inguinal hyperhidrosis in a patient with a mildly elevated autonomic symptom score being misdiagnosed as urinary incontinence

et al. 2021

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“…We also have noted that primary hyperhidrosis can have a significant psychologic impact on patients, and when effectively ameliorated, feelings of somatic anxiety subside. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

Inguinal hyperhidrosis in a patient with a mildly elevated autonomic symptom score being misdiagnosed as urinary incontinence

et al. 2021

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“…Successful treatment of hyperhidrosis may improve symptoms of depression and anxiety among affected patients. For example, in a study conducted in the USA, among patients with primary focal hyperhidrosis who underwent endoscopic thoracic sympathectomy, more than half of patients who were treated with psychotropic medications prior to surgery reduced their medication regimen, and depression and anxiety scale scores were also improved after surgery [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment Patterns, Depression, and Anxiety Among US Patients Diagnosed with Hyperhidrosis: A Retrospective Cohort Study

Klein

Hüll

Gillard

et al. 2020

Dermatol Ther (Heidelb)

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Introduction Hyperhidrosis is associated with social and emotional stress due to limitations on health-related quality of life. This study examined real-world treatment patterns and concomitant depression and/or anxiety in patients with hyperhidrosis. Methods Commercial health plan members in the US with ≥ 2 hyperhidrosis diagnosis codes and/or antiperspirant prescription claims were identified from January 2010 through November 2017. A control cohort (CC) of patients without hyperhidrosis was matched to the hyperhidrosis cohort on demographic characteristics. Depression and/or anxiety were identified by ≥ 1 relevant diagnosis code or pharmacy claim. A multivariable logistic regression model estimated odds of treatment in the hyperhidrosis cohort, and depression/anxiety in the hyperhidrosis cohort and CC, adjusting for patient characteristics. Results A total of 44,484 patients with hyperhidrosis were identified, of whom 58.5% were female, with a mean (± standard deviation) age of 36.5 ± 16.5 years (83.5% ≥ 18 years). A small majority of patients (51.6%, 0.69/person-year) received treatment with prescription antiperspirants. Post-index oral systemic therapies, medical procedures, and surgical options were uncommon. At 12 months post-index, 48.4% of the sample had not filled a prescription for extra- or prescription-strength antiperspirants. Compared with the CC ( n = 137,451), a higher percentage of patients with hyperhidrosis had depression or anxiety reported during follow-up (41.1 vs. 28.2%, p < 0.001); this corresponded to higher adjusted odds of depression/anxiety in patients with hyperhidrosis [odds ratio (OR) 1.76, 95% confidence interval (CI) 1.72–1.80, p < 0.001]. Baseline depression and/or anxiety were associated with lower odds of receiving hyperhidrosis treatment (OR 0.77, 95% CI 0.73–0.80), as was increasing age and male gender. Patients with hyperhidrosis also had more frequent incident depression/anxiety during follow-up (18.2 vs. 10.6%, p < 0.001). Conclusion In this real-world analysis, hyperhidrosis was associated with increased odds of depression and/or anxiety. However, relatively low percentages of patients received prescription topical or oral treatments or underwent surgery, suggesting that tolerability, efficacy, and provider awareness may be limiting factors in the effective treatment of hyperhidrosis. Electronic supplementary material The online version of this article (10.1007/s13555-020-00439-y) contains supplementary material, which is available to authorized users.

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“…Although several studies have evaluated the variation in patients' QoL with HH before and after treatment, few studies have evaluated the symptoms of anxiety and depression in patients with HH (10,(14)(15)(16)(17)(18)(19)(20). To our knowledge, no study has analyzed the changes in the symptoms of anxiety and depression after the clinical treatment of HH with oxybutynin.…”

Section: ' Introductionmentioning

confidence: 99%

Symptoms of anxiety and depression in patients with primary hyperhidrosis and its association with the result of clinical treatment with oxybutynin

Kamikava

Wolosker

Silva

et al. 2021

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Studies have identified correlations between the psychological characteristics of individuals with primary hyperhidrosis (HH), the degree of sweating, and the quality of life (QoL). This study aimed to evaluate the prevalence of anxiety and depression symptoms in patients with HH before and after oxybutynin treatment. METHODS: Data were collected from 81 patients. Palmar or axillary HH was the most frequent complaint (84.0%). All patients were evaluated before the medication was prescribed and after five weeks of treatment. The Beck Depression Inventory and Beck Anxiety Inventory were used to evaluate depression and anxiety. RESULTS: Improvement in HH occurred in 58 patients (71.6%), but there was no improvement in 23 patients (28.4%). The QoL before treatment in all patients was either ''poor'' or ''very poor.'' Patients who experienced improvement in sweating rates also experienced a greater improvement in QoL than patients who did not experience improvement in sweating at the main site (87.9% vs. 34.7%) (po0.001). A total of 19.7% of patients showed an improvement in their level of depression, and a total of 46.9% of patients exhibited improvements in their level of anxiety. A significant correlation was observed between sweating and anxiety (p=0.015). CONCLUSION: Patients with HH who experienced improvements in sweating immediately after treatment with oxybutynin exhibited small improvements in their levels of depression and significant improvements in their levels of anxiety and QoL.

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Endoscopic thoracic sympathectomy for primary focal hyperhidrosis: impact on psycho-social symptomatology and psychotropic medication use

Cited by 17 publications

References 31 publications

Inguinal hyperhidrosis in a patient with a mildly elevated autonomic symptom score being misdiagnosed as urinary incontinence

Inguinal hyperhidrosis in a patient with a mildly elevated autonomic symptom score being misdiagnosed as urinary incontinence

Treatment Patterns, Depression, and Anxiety Among US Patients Diagnosed with Hyperhidrosis: A Retrospective Cohort Study

Symptoms of anxiety and depression in patients with primary hyperhidrosis and its association with the result of clinical treatment with oxybutynin

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