Differences in Depression and Distress Between Acne Patients on Isotretinoin vs Oral Antibiotics

Hekmatjah, Joshua; Chat, Vipawee S; Sierro, Tiffany; Read, Charlotte; Kassardjian, A.; Armstrong, April W.

doi:10.36849/jdd.5559

Cited by 6 publications

(6 citation statements)

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“…37 This fear has now largely been put to rest, as acne patients treated with isotretinoin do not appear to have an increased risk of depression. 38,39 Our results confirm that patients with untreated acne have a numerical trend for increased risk of depression. The interpretation of these results is further dependent on the minimal clinically important difference (MCID).…”

Section: Discussionsupporting

confidence: 75%

The Social and Psychological Impact of Acne Treatment: A Cross-Sectional Study of Blood Donors

et al. 2022

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Background Acne in adolescence and adulthood is believed to have a long-term impact on socioeconomic status (SES) and health-related quality-of-life (HRQoL) in adults. Objective To estimate the cross-sectional prevalence of medically treated (MedTreAc) and untreated acne (UnTreAc) and to characterize its long-term impact in adults. Methods A nationwide cross-sectional study on 17 428 blood donors aged 18-35 was performed. Associations among acne and HRQoL, depressive symptoms, total income, and SES were investigated via linear/logistic/multinomial logistic regression analyses adjusted for relevant covariables. HRQoL was measured by the Short Form-12, and depressive symptoms by the Major Depression Inventory. The data were self-reported. Results Of the participants, 3591 (20.6%) and 1354 (7.8%) identified as the MedTreAc and UnTreAc phenotype, respectively. Neither phenotype was associated with a long-term impact on total income, but the MedTreAc group was associated with being an apprentice/student (OR = 1.26; 95% CI: 1.12, 1.42; P = 1.3×10-4) or high skill-level employee (OR = 1.22, 95% CI: 1.07; 1.39, P = .0023), while self-employment was more common for those with UnTreAc (OR = 1.53; 95% CI: 1.12, 2.06, P = .0061). Additionally, the UnTreAc group was associated with a lower mental HRQoL (SF-12 mental component summary score −1.05, 95% CI: −1.56, −0.54; P = 1.4×10-9) and increased odds ratio of depressive symptoms (OR = 1.44; 95% CI: 1.00, 2.02, P = .046). Conclusion In this population of blood donors, the cumulative prevalence of MedTreAc and UnTreAc were 20.6% and 7.8%, respectively. Untreated acne had a long-term impact on psychosocial well-being in adulthood. It was associated with lower mental HRQoL and higher occurrence of depressive symptoms. Acne was not associated with a lower salary or SES.

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Section: Discussionsupporting

confidence: 75%

The Social and Psychological Impact of Acne Treatment: A Cross-Sectional Study of Blood Donors

et al. 2022

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“…Our results add to the evidence that has suggested improvement in symptoms of anxiety 17 and depression 16,20 in individuals treated with isotretinoin. A recent observational study also found reduced symptoms of depression in patients treated with isotretinoin than in patients prescribed oral antibiotics 23 . Compared with patients with acne who had prescriptions for topical anti‐acne agents, presumably for less severe acne, we observed a statistically nonsignificant association for nonfatal self‐harm among patients treated with isotretinoin (one excess case per 1000 person‐years, OR 1·22, 95% CI 0·93–1·59).…”

Section: Discussionsupporting

confidence: 46%

“…A recent observational study also found reduced symptoms of depression in patients treated with isotretinoin than in patients prescribed oral antibiotics. 23 Compared with patients with acne who had prescriptions for topical anti-acne agents, presumably for less severe acne, we observed a statistically nonsignificant association for nonfatal self-harm among patients treated with isotretinoin (one excess case per 1000 person-years, OR 1Á22, 95% CI 0Á93-1Á59). However, a contrasting, statistically nonsignificant association was observed when the isotretinoin-exposed cohort were compared with those with prescriptions for oral antibiotics (OR 0Á85, 95% CI 0Á66-1Á11).…”

Section: Discussionmentioning

confidence: 58%

Isotretinoin and adverse neuropsychiatric outcomes: retrospective cohort study using routine data*

et al. 2022

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“…What is more, Tapio et al 86 also reported that compared with acne patients who were propensity score-matched and prescribed oral antibiotics, ISO was associated with lower rates of anxiety, sleep problems, non-fatal self-harm, and prescription of psychotropic medications. Similarly, Kridin et al 85 also reported that patients under ISO had less psychological distress, 87 lower risk of post-traumatic stress disorder, anxiety, bipolar disorder, schizophrenia, and adjustment disorder relative to those treated with oral antibiotics.…”

Section: Resultsmentioning

confidence: 95%

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

Ding¹,

Zheng²,

Jin³

2023

CCID

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Isotretinoin (ISO) is a powerful vitamin A derivative that offers the potential for treatment of permanent remission of acne; however, its potential side effects on both physiological and psychological aspects limit its application. This article reviews the side effects of ISO from physiological and psychological aspects in detail, to better screen the suitable population of ISO and improve the efficiency of clinical treatment. Our findings indicate that ISO may cause teratogenicity, skin reactions, ocular reactions, changes in blood indicators, and occasional acne fulminans. To optimize clinical treatment, more attention should be paid to identifying the specific conditions under which these reactions occur, how severe they are, and how they subside to alleviate patient concerns. Regarding the controversial issue of psychological side effects caused by ISO, researchers should shift their focus to the psychological problems that acne itself may cause.

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Differences in Depression and Distress Between Acne Patients on Isotretinoin vs Oral Antibiotics

Cited by 6 publications

References 0 publications

The Social and Psychological Impact of Acne Treatment: A Cross-Sectional Study of Blood Donors

The Social and Psychological Impact of Acne Treatment: A Cross-Sectional Study of Blood Donors

Isotretinoin and adverse neuropsychiatric outcomes: retrospective cohort study using routine data*

Physiological and Psychological Effects of Isotretinoin in the Treatment of Patients with Acne: A Narrative Review

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