Rosacea is significantly associated with depression and anxiety and may also predispose patients to develop these mental health disorders, according to findings from a systematic review published in the Journal of Affective Disorders.

Investigators performed a systematic review of relevant observational studies–those that compared the incidence or prevalence of depression or anxiety between patients with and without rosacea. Investigators then conducted meta-analyses with a random-effects model, with the main outcome being a pooled analysis of prevalence or incidence of depression and anxiety in patients with rosacea.

There were 9 studies, encompassing 101,114,209 patients with rosacea and 599,564,745 patients without rosacea, included in the analysis. The mean patient age ranged from 30 to 50 years. All studies were rated as high quality.


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The crude odds ratio (OR) from the pooled analysis of cross-sectional and case-control studies revealed that patients with rosacea were significantly more likely to have depression (crude OR, 2.855; 95% CI, 1.258-6.481; P =.012) and anxiety (crude OR, 2.373; 95% CI, 1.448-3.888; P =.001) than matched control participants. The adjusted OR (aOR) for depression also showed a significant association with rosacea (aOR, 3.328; 95% CI, 0.805-13.766; P =.097); however, the aOR for anxiety did not show a significant association.

The meta-analysis from cohort studies showed a significantly higher incidence of depression (adjusted incidence ratio [IRR], 2.443; 95% CI, 1.603-3.723; P <.001) and anxiety (IRR, 2.181; 95% CI, 1.660-2.864; P <.001) in patients with rosacea.

The study was limited by different methods used across studies to evaluate depression and anxiety, relatively small study numbers, and insufficient data for a subgroup analysis based on demographic factors.

“Physicians should evaluate psychological symptoms when diagnosing rosacea and should provide psychological counseling for patients as part of treatment,” the study authors wrote.

Reference

Chang HC, Huang YC, Lien YJ, Chang YS. Association of rosacea with depression and anxiety: A systematic review and meta-analysis.J Affect Disord. Published online December 5, 2021. doi:10.1016/j.jad.2021.12.008