Hull Peter R, D'Arcy Carl
Division of Dermatology, Department of Medicine, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, Canada S7N 0W8.
Dermatol Clin. 2005 Oct;23(4):665-74. doi: 10.1016/j.det.2005.05.008.
Acne is a common disorder that may have a considerable psychologic impact including anxiety and depression. Depression and suicide occur frequently in adolescents and young adults. Although case reports suggest an association between isotretinoin and depression and suicide, more rigorous observational studies and epidemiologic studies, using different designs, have not shown any effect of isotretinoin use in increasing the occurrence of depression and suicide. It is prudent for the practitioner to continue to use isotretinoin to treat severe acne, while at the same time informing patients and their relatives that depressive symptoms should be actively assessed at each visit and, if necessary, referral to a psychiatrist and a discontinuation of isotretinoin should be considered.
痤疮是一种常见疾病，可能会产生相当大的心理影响，包括焦虑和抑郁。抑郁和自杀在青少年及青年成年人中频繁发生。尽管病例报告提示异维A酸与抑郁及自杀之间存在关联，但采用不同设计的更为严谨的观察性研究和流行病学研究并未显示使用异维A酸会增加抑郁和自杀的发生率。对从业者而言，谨慎的做法是继续使用异维A酸治疗重度痤疮，同时告知患者及其亲属在每次就诊时都应积极评估抑郁症状，如有必要，应转诊至精神科医生处，并考虑停用异维A酸。
