The relationship of psychopathology and hyperhidrosis

Background: Hyperhidrosis is a common yet poorly understood disease that is often exacerbated by emotional stress. While a psychiatric explanation of causality is frequently offered, there is little evidence to support or reject the view that the condition is primarily an anxiety-based disorder. Objectives: To quantify objectively the degree of psychopathology in patients with hyperhidrosis. Methods: Forty-two patients diagnosed as having hyperhidrosis were examined prior to endoscopic sympathectomies. All patients took the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and State-Trait Anxiety Inventory (STAI) before surgery. Results were compared with established norms. Results: The group scored well within established norms on both psychometric measures. On scales measuring anxiety, depression and conversion phenomena, 88% of the MMPI-2 profiles lacked elevations, and 86% of the patients lacked elevations on the STAI State and Trait Anxiety scales. Personality variables were not associated with postsurgical outcome. Conclusions: Most individuals suffering from essential hyperhidrosis lack overt psychopathology. While some patients subjectively describe symptoms of anxiety, mild depression and social isolation, these complaints appear often to be in reaction to or superimposed upon an organic disease process and not the primary cause of their condition.