Associations between Primary Hyperhidrosis and Psychiatric Conditions: A Matched Case-Control Study of 8,508 Patients

Introduction: Primary hyperhidrosis (PHH) is defined by excess sweating not attributable to medications or underlying medical conditions. It is associated with significant burden of subsequent psychiatric comorbidities, but psychiatric conditions preceding PHH diagnosis are not well characterized. We assessed associations of PHH with preceding psychiatric conditions using a matched case-control approach. Methods: Overall, 1,418 participants with PHH and 7,090 matched controls were assessed using the All of Us Research Program database. Multivariable logistic regressions calculated odds ratios and 95% confidence intervals, with Benjamini-Hochberg correction for multiple testing. Results: Subjects with PHH vs. controls had higher odds of prior diagnosis with Obsessive-Compulsive Disorder (OCD) (OR: 1.97, 95% CI: 1.29-2.94, corrected p=0.007), Restless Legs Syndrome (RLS) (OR: 1.63, 95% CI: 1.22-2.15, corrected p=0.007), Attention-Deficit/Hyperactivity Disorder (ADHD) (OR: 1.35, 95% CI: 1.07-1.69, corrected p=0.035), and insomnia (OR: 1.22, 95% CI: 1.04-1.44, corrected p=0.037). Conclusion: We found significant associations with subsequent PHH diagnosis in participants with OCD, ADHD, RLS, and insomnia. Further research into the etiologies of psychiatric conditions and PHH may better elucidate their relationship.