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Acne vulgaris and risk of depression and anxiety: A meta-analytic review

Danielle V. Samuels, PhD1,∗,Correspondence information about the author PhD Danielle V. SamuelsEmail the author PhD Danielle V. Samuels

, 

Robert Rosenthal, PhD2

, 

Rick Lin, DO MPH3,4

, 

Soham Chaudhari, DO3,4

, 

Misaki N. Natsuaki, PhD2

PlumX Metrics

DOI: https://doi.org/10.1016/j.jaad.2020.02.040

Article Info

• Abstract

Abstract

Background

Several studies have shown an association of acne vulgaris with depression and anxiety but a quantitative review has not yet been conducted.

Objective

To conduct a systematic review and meta-analysis that elucidates the association of acne vulgaris with depression and anxiety.

Method

A systematic review and meta-analysis of literature published prior to October 1, 2019 from PubMed, PsycINFO, MEDLINE, and Cochrane databases was conducted. We used a meta-analytic approach to perform a random effects analysis comparing individuals with and without acne. Subgroup analyses between studies included age, study setting, and geographic region.

Results

In all, 42 studies were included. We found a significant association of acne vulgaris with depression, r = 0.22 (95% CI: 0.17-0.26, p < .00001), and anxiety, r = 0.25 (95% CI: 0.19-0.31, p < .00001). Subgroup analyses and comparisons showed moderating influences based on factors including age, study setting, and geographic region.

Limitations

Inconsistency between publications regarding acne and outcome ascertainment, data reporting, and studies with no control group posed considerable barriers to synthesizing all available literature.

Conclusion

Because of increased risk for depression and anxiety, clinicians should pursue aggressive treatment of acne and consider psychiatric screening or referrals.

Key words:

acne, acne vulgaris, depression, anxiety, psychiatric morbidity, meta-analysis, meta-analytic review, adolescence