Background Since the introduction of isotretinoin to the market, many adverse psychiatric effects, including depression, anxiety and suicide attempts were reported. The aim of this study was to determine whether patients with acne who were treated with isotretinoin experienced significant increases in psychiatric symptoms over a 4-month period compared with patients who received topical acne therapy.Methods Seventy-eight acne patients were allocated either to isotretinoin treatment (study group) (n = 37) or to topical treatment (control group) (n = 41). Their psychological status was evaluated at the baseline, second and fourth months of the treatment. All patients were required to complete the dermatology life quality index (DLQI), the Hospital anxiety and depression (HAD) scale, and the beck depression inventory (BDI).
ResultsThe two groups were not different from each other in terms of DLQI, BDI, HAD-A, HAD-D and total HAD scores at baseline. However, at the end of the second month quality of life was more impaired in the topical treatment group compared to the isotretinoin group (P < 0.05), and there were no difference between two groups in terms of BDI, HAD-A, HAD-D, and total HAD scores (P > 0.05). At the end of fourth month quality of life and all psychological test scores had improved more in the isotretinoin group compared to topical treatment group (P < 0.05).
ConclusionResults of the present study indicate that there is no increase in depressive and anxiety symptoms in the isotretinoin treatment group compared to that in the topical group.Instead, successful treatment of acne seems to improve both depressive and anxiety symptoms and improve quality of life.
IntroductionIsotretinoin is a synthetic oral retinoid that has great efficacy against severe, recalcitrant, nodulocystic acne. Since its introduction to the market, many adverse psychiatric effects, including depression, psychosis, mood swings, violent behavior, suicide, and suicide attempts were reported. [1][2][3] Although some case reports and open label studies investigated the association of depression and isotretinoin treatment, results were conflicting. 4,5 The overall lack of concrete scientific data limits any conclusion that can be drawn about a causal relationship between isotretinoin and adverse psychiatric events. 6 The incidence of depression in isotretinoin users is 0% in studies with a control group and 1-1.5% in studies without controls. These rates are similar to the incidence of depression in the general population, which is known to be about 1%. [6][7][8] Depression is a multifactorial disorder, and both acne and psychiatric disorders, 9,10 often affect people in the 15-24 years age group. Eighty-five to 90% of adolescents and young adults have some degree of acne. The main goal of acne treatment is to prevent physical scarring by limiting the number of lesions and the duration of the disease, thereby minimizing its psychological impact. 11,12 The psychological impact of acne is well documented, particularly in adolesce...