Acne vulgaris – Psychosomatic aspects

Abstract

More than a cosmetic nuisance, acne can produce anxiety, depression, and other psychological problems that affect patients' lives in ways comparable to life-threatening or disabling diseases. Emotional problems due to the disease should be taken seriously and included in the treatment plan. A purely dermatological therapy by itself may not achieve its purpose. Even mild to moderate disease can be associated with significant depression and suicidal ideation, and psychologic change does not necessarily correlate with disease severity. Acne patients suffer particularly under social limitations and reduced quality of life. Psychological comorbidities in acne are probably greater than generally assumed. Attention should be paid to psychosomatic aspects especially if depressive-anxious disorders are suspected, particularly with evidence of suicidal tendencies, body dysmorphic disorders, or also in disrupted compliance.Therefore, patients who report particularly high emotional distress or dysmorphic tendencies due to the disease should be treated, if possible, by interdisciplinary therapy. The dermatologist should have some knowledge of the basics of psychotherapy and psychopharmacology, which sometimes must be combined with systemic and topical treatment of acne in conjunction with basic psychosomatic treatment.

Factors associated with health-related quality of life among Belgrade University students

“…Arslan et al compared the SF-36 scores between students with (BDI more than 19) and without depression and also found that depression negatively affected all of the SF-36 domains. Similar results have been reported by many studies [13,26,27] which pointed out that depressive symptoms showed multi-dimensional impairment in HRQoL.…”

Adolescents with Skin Disease Have Specific Quality of Life Issues

“…As a result of bullying and negative comments, self-esteem was also affected in a number of patients. These issues have the potential to develop into more serious psychological disorders, such as depression and body dysmorphic disorder [14]. …”

“…However, no validated HRQoL instrument exists with a clear adolescent focus to capture the psychosocial effects of skin diseases in this particular age group [11]. The widely used Dermatology Life Quality Index (DLQI) [12] measures the HRQoL of adults (specified as those over 16), and the Children’s DLQI [14] is designed for the use in children aged between 5 and 16 with skin disease. Since HRQoL issues for this age group can differ greatly, it may not be appropriate to use the same questionnaire in both immature 5-year-olds and maturing 15-year-olds.…”

Anxiety, depression, social phobia, and quality of life in Turkish patients with acne and their relationships with the severity of acne

“…Many psychological problems associated with acne have been reported to date. These include decrease in self-esteem, impaired overall perception of his/her well-being and selfimage, embarrassment, fear of rejection, social withdrawal, anger, restrictions in lifestyle, problematic family relations, excessive mental engagement in his/her acne, depression, and anxiety (4); higher risks of suicide have even been reported in patients with acne (5,6). The mental health impairment scores among acne patients are higher compared to a number of other chronic, nonpsychiatric medical conditions, including epilepsy and diabetes (7).…”