Abdul Shakoor, Jameel Ahmad Shaheen, Jaffar Iqbal Khan.
Association of anxiety and depression with acne: evaluation of pathoplastic effect of adolescence on this comorbidity.
J Pak Assoc Derma Jan ;22(4):336-41.

Objective To see the association of anxiety and depression with acne and to observe pathoplastic effect of adolescence on this comorbidity. Patients and methods This cross-sectional study was conducted in the out-patients of department of Dermatology, Bahawal-Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur, from January 01, 2011 to June 30, 2011. After taking written informed consent from each patient, we enrolled 101 patients of acne diagnosed by consultant dermatologist .The severity of acne was determined according to the Global Acne Grading System. The patients of both sexes of the age ranging from 10-39 years were included in the study and divided into three groups (I=10-19y, II=20-29y, III=30-39y) to examine the effect of age on the disease .The patients with concomitant dermatological, psychiatric diseases and on systemic isotretinoin were excluded. The patients fulfilling inclusion criteria were administered Urdu version of Hospital Anxiety and Depression Scale by senior psychiatrist assisted by his team. The score obtained from each patient was used to categorize non-caseness (0-7), mild anxiety and mild depression (8-10), moderate anxiety and moderate depression (11-15) and severe anxiety and severe depression (16-21). Results Out of 101 patients studied, 35.6% were males and 64.4% females with M: F ratio of I: I.8. 81.18% of the acne patients were having anxiety, 70.29% depression and 18-29% had no psychiatric complication. The large majorities of the enrolled patients were suffering from mild anxiety (76.8%) and mild depression (83.1%). Only the patients with moderate acne had severe anxiety (2.4%) and severe depression (1.4%). 88.1% of the acne patients had duration of illness less than 5 year against 11.9% with duration more than 5 years (p<0.05). We found continuous decrease in the frequency of anxiety and depression as the acne patients’ age progressed without going into severe psychological handicap. Conclusion There is high association of anxiety and depression with acne. But no linear relationship between the severities of anxiety and depression with those of acne is found. High frequency of mild anxiety and mild depression in adolescence decreases as the age progresses, which may be due to the pathoplastic effect of the younger age.

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