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

J Am Acad Dermatol. 2020 Aug;83(2):532-541. doi: 10.1016/j.jaad.2020.02.040. Epub 2020 Feb 20.

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: We sought to conduct a systematic review and meta-analysis that elucidates the association of acne vulgaris with depression and anxiety.

Methods: A systematic review and meta-analysis of literature published before October 1, 2019 from the PubMed, PsycINFO, MEDLINE, and Cochrane databases was conducted. We used a metaanalytic 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: Forty-two studies were included. We found a significant association of acne vulgaris with depression (r = 0.22 [95% confidence interval 0.17-0.26, P < .00001]) and anxiety (r = 0.25 [95% confidence interval 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 published literature.

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

Keywords: acne; acne vulgaris; adolescence; anxiety; depression; meta-analysis; meta-analytic review; psychiatric morbidity.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Acne Vulgaris / complications*
  • Acne Vulgaris / psychology
  • Acne Vulgaris / therapy
  • Adolescent
  • Adult
  • Age Factors
  • Anxiety / diagnosis
  • Anxiety / epidemiology*
  • Anxiety / etiology
  • Anxiety / prevention & control
  • Depression / diagnosis
  • Depression / epidemiology*
  • Depression / etiology
  • Depression / prevention & control
  • Dermatology / standards
  • Humans
  • Mass Screening / standards
  • Practice Guidelines as Topic
  • Psychiatry / standards
  • Psychology, Adolescent
  • Referral and Consultation / standards
  • Risk Factors
  • Self Concept