Acne (i.e. acne itself, not any medication) linked to suicidal ideation and depression in adolescents…

Adolescents with substantial acne have more frequent suicidal ideation and depression than those without the skin condition, say researchers who believe this is likely to be a result of the burden of acne rather than an adverse therapy-associated effect.

Writing in the Journal of Investigative Dermatology, Jon Halvorsen (University of Oslo, Norway) and colleagues report the results of a cross-sectional, questionnaire-based study of 3775 Norwegian 18-19 year olds.

Overall, 14% of the cohort had self-reported substantial acne, whereas the remaining participants had no or little acne.

Girls with substantial acne had twice as much suicidal ideation as girls with no or little acne, at 25.5% versus 11.9%, whereas boys with substantial acne had three times as much suicidal ideation as their peers without the condition, at 22.6% versus 6.3%.

Overall, substantial acne was associated with a significant 80% increase in relative risk for suicidal ideation.

In addition, relative risks for having mental problems (assessed by Strengths and Difficulties Questionnaire), low attachment to friends, not thriving at school, never having had sex, or a romantic relationship were increased 2.25-, 1.52-, 1.41-, 1.51-, and 1.35-fold, respectively, in adolescents with substantial acne compared with their acne-free counterparts.

“An association between isotretinoin therapy and increased risk of depression, suicidal ideation, and suicide has been claimed, but the current literature is conflicting and results from controlled studies are lacking,” say the researchers.

They believe that the adverse psychological events such as suicidal ideation and depression experienced by those with substantial acne may more accurately mirror the burden of substantial acne rather than the effects of acne medications.

“Our results are helpful for clinicians, as subjective complaints are important when choosing treatment,” write Halvorsen et al.

“Furthermore, these findings have public health implications because they underscore the need of appropriate health care for adolescent boys and girls in the community,” they conclude.

J Invest Dermatol, MedWire

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