Acne vulgaris is associated with an increased risk for anxiety and depression, according tostudy research in the Journal of the American Academy of Dermatology. Clinicians should therefore treat acne aggressively and consider referring patients for mental health consultation,
The meta-analysis and systematic review included 42 studies published before October 1, 2019, on MEDLINE, PsycINFO, PubMed, and the Cochrane Library databases. The studies were noninterventional and included patients with comorbid acne and depression/anxiety. Studies were assessed for heterogeneity by examining methodological, statistical, and clinical variation. Interstudy subgroup analyses were performed with respect to age (adolescent vs adult), geographic region (5 regions), and study setting (community vs clinical).
Of 1,029,299 included patients with depression, those with acne were more likely to experience depression than those without acne (mean correlation, r =0.22; 95% CI, 0.17-0.26; P <.00001); this trend was stronger in adults vs adolescents (P =.016) and in those patients seen in clinical settings vs community settings (P <.004). The same association was observed in the 21,634 patients with anxiety (mean correlation, r =0.25; 95% CI, 0.19-0.31; P <.00001); this trend was stronger in adults than adolescents (P =.041) and in clinical vs community settings (P =.011).
Limitations to this study include high variability of study results and data reporting and an inability to draw causal inference.
The study researchers concluded that “acne and psychological suffering are associated.” The study quantifies the significance of this problem, underscoring the “need for an interdisciplinary approach between psychology and dermatology for optimal acne treatment and patient care.” Furthermore, the study researchers state that clinical guidelines may need to be reevaluated, as undertreatment of acne appears to be related to risk for psychological comorbidity.
Samuels DV, Rosenthal R, Lin R, Chaudhari S, Natsuaki MN. Acne vulgaris and risk of depression and anxiety: a meta-analytic review [published online February 20, 2020]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2020.02.040