Effects of isotretinoin on obsessive compulsive symptoms, depression, and anxiety in patients with acne vulgaris

Background: Depression, anxiety, and obsessive compulsive symptoms are known to be common among patients with acne vulgaris. In contrast to earlier reports, a number of recent studies suggested isotretinoin to be beneficial for depression and anxiety symptoms in acne patients. Moreover, its effects on obsessive compulsive symptomatology are still widely unknown. Objectives: To examine the effects of isotretinoin treatment on obsessive compulsive symptoms, depression, and anxiety in acne vulgaris patients. Methods: The Hospital Anxiety and Depression Scale, Maudsley Obsessive Compulsive Questionnaire, and Sheehan Disability Scale were administered to 43 patients with acne vulgaris who accepted isotretinoin treatment and agreed to participate in the study. Severity of acne was evaluated with Global Acne Grading System. Thirty-three patients completed 6 months treatment with oral isotretinoin at 0.5-1.0 mg/kg daily doses. Measurements were repeated at the end of 6 months. Results: Depression, anxiety, and obsessive rumination symptoms were significantly improved after isotretinoin treatment. On the other hand, obsessive doubting of acne patients was worse at the end of the treatment. There was no significant change in disease related disability of patients. Conclusion: Besides worsening of obsessive doubting, successful treatment with oral isotretinoin seems to be related with improvement in depression, anxiety, and obsessive rumination symptoms in acne vulgaris patients. These changes were not reflected in the disability level that acne patients have reported.