Increased frequency of Attention Deficit Hyperactivity Disorder (ADHD) in acne versus dermatologic controls: analysis of an epidemiologic database from the US

Introduction: Acne can be associated with psychiatric morbidity and suicide, which have sometimes been considered an adverse reaction to some acne therapies such as isotretinoin. A recent population-based study reports that suicide in acne is related to the psychosocial burden of substantial acne, rather than medication effects. As suicidality is not always directly related to acne severity, factors other than acne's direct psychosocial burden also likely contribute to the suicide risk. Attention Deficit Hyperactivity Disorder (ADHD) is a disorder of childhood and adolescence that is associated with increased suicidality. We examined the frequency of ADHD in acne versus all other dermatology-related patient visits, after controlling for age and other factors. Methods: Retrospective cross-sectional study of epidemiologic databases (NAMCS and NHAMCS) representing 55 825 dermatology outpatient visits from 1995 to 2009. Results: In comparison to other dermatologic disorders, acne was over two times more likely to be associated with ADHD (odds ratio = 2.34, 95%CI 1.06-5.14) after controlling for the possible confounding effects of age, sex, stimulant medications, comorbid anxiety or depressive disorders, and atopic dermatitis, a condition previously associated with ADHD. Discussion: Our preliminary findings suggest a significant association of acne with ADHD, which could contribute to the increased psychological morbidity and suicidality in some acne patients.