Depression among adolescents with acne vulgaris: A cross-sectional assessment

Background: The prevalence of depression among adolescents and young adults with acne vulgaris has varied widely in different studies. Purpose: The purpose of this study is to assess the prevalence of depression among adolescents with acne vulgaris as compared to age and gender-matched healthy adolescents. The effects of the severity of acne (and postacne scars), duration of acne, and treatment on the severity of depression among adolescents with acne have also been assessed in this study. Methods: The patient health questionnaire-9 was completed by each one of 1502 adolescents with acne vulgaris and 1500 age and gender-matched controls in this cross-sectional study. The association of prevalence and severity of depression with gender, duration of acne, grade of acne, treatments received, and presence and severity of postacne scars was explored by Chi-square test for categorical variables and t-test for quantitative variables. Results: One hundred and thirty (8.65%) adolescents with acne vulgaris were diagnosed with depression, while only 5 (0.33%) healthy adolescents were diagnosed with depression (P = 0.005). Among adolescents with acne vulgaris, 2 (0.13%) had severe depression, 4 (0.27%) had moderately severe depression, 11 (0.73%) had moderate depression, and 113 (7.52%) had mild depression. There was no association of severity of depression with gender, grade of acne (and postacne scars), duration of acne, and treatment received. Conclusion: Acne and postacne scars are associated with a significant prevalence of depression among adolescents with acne independent of treatment received. Clinicians should consider incorporating depression screening and referral system in their workflow with adolescents who access them for acne treatment to achieve better clinical outcomes.