isotretinoin and Anxiety-Disorders

The psychological consequences of acne have been the subject of many studies. As a particularly visible skin disorder, acne complicates the daily lives of adolescents who are undergoing multiple transformations: physical, intellectual and emotional. While it is well established that acne can be responsible for depression and low self-esteem, it is likely that this impact is aggravated by the sociological evolution of adolescents in the 21st century. Understanding the codes of adolescents today (who can be characterized as being more concerned by their appearance than previous generations at the same age) allows us to optimize our medical approach to acne and facilitates treatment compliance and adherence.

Topics: Acne Vulgaris; Adolescent; Adult; Anxiety Disorders; Attitude to Health; Depressive Disorder; Dermatologic Agents; Emotions; Female; Humans; Isotretinoin; Male; Mental Health; Mood Disorders; Physician-Patient Relations; Psychiatric Status Rating Scales; Surveys and Questionnaires; Young Adult

Acne vulgaris (AV) is a chronic inflammatory skin disease that affects millions of people. Psychologic disorders such as depression, anxiety, and body dysmorphic disorder are common in patients with AV and the reported prevalence of suicidal ideation and suicide completion in acne patients also is remarkable. Part 1 of this series provided an overview of the prevalence of psychologic disorders in patients with AV Part 2 reviews depression, anxiety, body dysmorphic disorder, and suicidal ideation and completion seen in AV patients. Treatments available for acne patients with coexisting psychiatric illness also are discussed, along with the relationship between oral isotretinoin and depression and suicide.

Topics: Acne Vulgaris; Anxiety Disorders; Body Dysmorphic Disorders; Depression; Dermatologic Agents; Humans; Isotretinoin; Mental Disorders; Risk; Suicidal Ideation; Suicide

Depression, anxiety, and obsessive compulsive symptoms are known to be common among patients with acne vulgaris. In contrast to earlier reports, a number of recent studies suggested isotretinoin to be beneficial for depression and anxiety symptoms in acne patients. Moreover, its effects on obsessive compulsive symptomatology are still widely unknown.. To examine the effects of isotretinoin treatment on obsessive compulsive symptoms, depression, and anxiety in acne vulgaris patients.. The Hospital Anxiety and Depression Scale, Maudsley Obsessive Compulsive Questionnaire, and Sheehan Disability Scale were administered to 43 patients with acne vulgaris who accepted isotretinoin treatment and agreed to participate in the study. Severity of acne was evaluated with Global Acne Grading System. Thirty-three patients completed 6 months treatment with oral isotretinoin at 0.5-1.0 mg/kg daily doses. Measurements were repeated at the end of 6 months.. Depression, anxiety, and obsessive rumination symptoms were significantly improved after isotretinoin treatment. On the other hand, obsessive doubting of acne patients was worse at the end of the treatment. There was no significant change in disease related disability of patients.. Besides worsening of obsessive doubting, successful treatment with oral isotretinoin seems to be related with improvement in depression, anxiety, and obsessive rumination symptoms in acne vulgaris patients. These changes were not reflected in the disability level that acne patients have reported.

Topics: Acne Vulgaris; Adolescent; Adult; Anxiety Disorders; Depressive Disorder; Dermatologic Agents; Female; Humans; Isotretinoin; Male; Obsessive-Compulsive Disorder; Quality of Life; Severity of Illness Index; Treatment Outcome; Young Adult

Although knowledge concerning the dermatological treatment of chronic acne has grown considerably in recent years, relatively few studies have assessed the impact of effective physical intervention upon the psychoemotional functioning of patients. Hypotheses regarding the psychological impact of acne were developed using concepts drawn from evolutionary psychology. A sample of 34 patients (19 men and 15 women) with chronic acne were assessed for psychological, emotional and dermatological symptomatology using a variety of self-report questionnaires over four time-points during 16 weeks treatment with isotretinoin. Thirty-four patients completed the first assessment, 21 the second, 20 the third and 15 the fourth and final assessment. At the first assessment, prior to isotretinoin treatment, 15 patients (44%) reported clinically significant levels of anxiety, while six patients (18%) reported clinically significant depression. Women with acne were significantly more embarrassed than their male counterparts about their skin disease. Treatment with isotretinoin produced significant improvements across a wide variety of psychological functions, although the emotional status of patients appeared to be more resistant to change. Acne appears to be a condition which has the potential to damage, perhaps even in the long term, the emotional functioning of some patients.

Topics: Acne Vulgaris; Adolescent; Adult; Anxiety Disorders; Chronic Disease; Depressive Disorder; Emotions; Female; Follow-Up Studies; Humans; Isotretinoin; Keratolytic Agents; Male; Mental Disorders; Psychiatric Status Rating Scales; Psychometrics