Author

Study Size (n)

Methods

Results

Quality of Life

Uslu et al, 2008

600

GHQ, RSES

Acne severity directly correlated to anxiety, depression and lower self-esteem.

Walker et al, 2005

200

CDLQI, CADI

Acne correlated with significantly impaired QoL and disability.

Pawin et al, 2007

1,566

Adapted CADI

Acne impacted daily life, relationships, and feelings of anger, anxiety. Psychological effect of acne equivalent to that of diabetes, cancer, and epilepsy.

Balkrishnan et al, 2006

73

HRQOL, FNE

Psychological factors, including FNE correlated with poorer HRQOL.

Rapp et al, 2006

480

Acne-QOLI

Questionnaire assessment of QoL with good validity, internal consistency, and test-retest reliability in clinical setting.

Self-esteem

Hassan J et al, 2009

132

DAS, acne self assessment

Acne correlated with higher self-consciousness and negative self-concept in women than men and higher self-consciousness of sexual and bodily appearance in non-white compared to white males.

Dalgard F et al, 2008

3,775

Questionnaire

Acne correlated with poor self-attitude in boys  and poor self-worth in girls independently of body mass index and depressive symptoms

Magin P et al, 2006

26

Standardized interview

Acne caused immediate psychological consequences of negative self esteem, poor self image, self consciousness and embarrassment and had long-term effects on personality.

317

SDQ, acne management questionnaire

Significantly higher emotional and behavioral difficulties in subjects with acne.

Personality and Mood

479

Questionnaire

High Trait Anger (TA) correlated with poorer global and skin-related quality of life and decreased treatment satisfaction and compliance.

Krejci-Manwaring J et al, 2006

479

Survey

Dispositional social sensitivity was correlated with acne severity and poorer social outcomes in women and worse social outcomes and poorer quality of life in men.

Psychological Disorders

Purvis D et al, 2006

9,567

Survey

Depressive symptoms correlated with acne severity. Increased suicidal thoughts and suicide attempts associated with problem acne.

Uhlenhake E et al, 2010

9.6 million

Medical claims database

Clinical depression more prevalent in acne patients compared to general population.

Bowe WP et al, 2007

128

Questionnaire

14.1 - 21.1% of acne patients have Body Dysmorphic Disorder. BDD two times more common in patients treated with systemic isotretinoin therapy. 

Hahm BJ et al, 2009

38

APSEA, BDI

Patients receiving isotretinoin had significantly decreased depressive symptoms within 2 weeks of initiating treatment. Depression correlated with decreased quality of life, but not acne severity.

Kaymak Y et al, 2009

78

DLQI, HAD, BDI

Quality of life was improved in patients treated with isotretinoin compared to topical acne therapies. No difference in incidence of depression or anxiety between treatments.