Anxiety, Depression, and Suicidal Ideation amongst Patients with Facial Dermatoses (Acne, Rosacea, Perioral Dermatitis, and Folliculitis) in Lithuania

Dermatology. 2020;236(4):314-322. doi: 10.1159/000506627. Epub 2020 Apr 6.

Abstract

Background/objective: Skin diseases, especially those with visible manifestation, are considered to cause a major influence on global mental health. Therefore, we determined the prevalence and severity of anxiety, depression, and suicidal ideation in a large sample of patients with facial dermatoses, namely acne, rosacea, folliculitis, and perioral dermatitis.

Methods: The mental health of patients with facial dermatoses and respective controls was assessed using the Hospital Anxiety and Depression Scale and questions concerning suicidal ideation.

Results: The study included 543 patients with facial dermatoses and 497 healthy individuals. Anxiety was present in 37.6% of the patients (14.9% of controls), depression in 21.7% (6.8%), and suicidal thoughts in 9.8% (3.2%) (p < 0.001). Acne patients demonstrated the highest anxiety and depression subscale scores (mean ± standard deviation: 7.1 ± 0.25, 95% confidence interval (CI): 6.58-7.56; controls: 5 ± 0.23, 95% CI: 4.57-5.49). In rosacea 30% of the patients had depression symptoms (adjusted odds ratio (OR): 7.216, 95% CI: 4.122-12.632, p < 0.001), while in folliculitis patients 15.4% (OR: 3.138, 95% CI: 1.241-7.936, p = 0.016) had suicidal thoughts. Patients with anxiety symptoms and suicidal thoughts were on average younger than those without (28.3 ± 0.76 vs. 31.2 ± 0.66 years, p = 0.001 and 25.3 ± 0.98 vs. 30.5 ± 0.55 years, p = 0.007, respectively).

Conclusion: Acne and rosacea are associated with anxiety, depression, and suicidal ideation in Lithuanian patients. Younger patients are more prone to report such symptoms than older ones.

Keywords: Acne; Anxiety; Depression; Folliculitis; Perioral dermatitis; Rosacea; Suicide.

MeSH terms

  • Acne Vulgaris / epidemiology
  • Acne Vulgaris / psychology
  • Adult
  • Age Factors
  • Anxiety / epidemiology*
  • Comorbidity
  • Depression / epidemiology*
  • Dermatitis, Perioral / epidemiology
  • Dermatitis, Perioral / psychology
  • Facial Dermatoses / epidemiology*
  • Facial Dermatoses / psychology*
  • Female
  • Folliculitis / epidemiology
  • Folliculitis / psychology
  • Humans
  • Lithuania / epidemiology
  • Male
  • Prevalence
  • Risk Factors
  • Rosacea / epidemiology
  • Rosacea / psychology
  • Sex Factors
  • Suicidal Ideation*
  • Suicide / statistics & numerical data
  • Young Adult