Hahm Bong Jin, Min Seong Uk, Yoon Mi Young, Shin Yong Wook, Kim Jin Sook, Jung Jae Yoon, Suh Dae Hun
Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
J Dermatol. 2009 May;36(5):255-61. doi: 10.1111/j.1346-8138.2009.00635.x.
Oral isotretinoin is a highly effective agent for the treatment of moderate to severe acne, but ever since oral isotretinoin was introduced as a modality for acne, the relationship between oral isotretinoin therapy and psychiatric problems, especially depression, has been controversial. The purposes of this study were to know the acute effects of oral isotretinoin therapy on psychiatric symptoms and to investigate the relationships among them, which have not been reported in the published work. This cohort study included 38 acne patients who started oral isotretinoin therapy. Individual patients were examined before administering oral isotretinoin and 2 and 8 weeks after commencement. Acne severity was graded using the Leeds revised acne grading system. Acute psychiatric effects of oral isotretinoin were assessed using a questionnaire authorized by two psychiatrists. This questionnaire included assessments of acne-related quality of life (Assessment of the Psychological and Social Effects of Acne [APSEA]), depression (Beck's depression inventory [BDI]), anxiety (Beck's anxiety inventory [BAI]) and psychopathology (Symptomchecklist-90-revised [SCL-90-R]). Acne grading and APSEA showed similar change patterns. Both improved after 8 weeks of oral isotretinoin treatment. On the other hand, the severity of depression decreased after 2 weeks of treatment. A significant correlation was found between BDI and APSEA, but no correlation was found between BDI and acne grade. These results indicate that oral isotretinoin therapy alleviates depressive symptoms. Improvements in depression are directly related to acne-related life quality improvements rather than to improvement in acne grade.
口服异维A酸是治疗中度至重度痤疮的一种高效药物，但自从口服异维A酸作为一种痤疮治疗方式被引入以来，口服异维A酸治疗与精神问题，尤其是抑郁症之间的关系一直存在争议。本研究的目的是了解口服异维A酸治疗对精神症状的急性影响，并调查它们之间的关系，而这些在已发表的文献中尚未有报道。这项队列研究纳入了38名开始口服异维A酸治疗的痤疮患者。在给予口服异维A酸之前以及开始治疗后2周和8周对个体患者进行检查。使用利兹修订痤疮分级系统对痤疮严重程度进行分级。使用由两名精神科医生认可的问卷评估口服异维A酸的急性精神影响。该问卷包括对痤疮相关生活质量（痤疮的心理和社会影响评估[APSEA]）、抑郁（贝克抑郁量表[BDI]）、焦虑（贝克焦虑量表[BAI]）和精神病理学（症状自评量表90修订版[SCL-90-R]）的评估。痤疮分级和APSEA显示出相似的变化模式。口服异维A酸治疗8周后两者均有所改善。另一方面，治疗2周后抑郁严重程度降低。BDI与APSEA之间存在显著相关性，但BDI与痤疮分级之间未发现相关性。这些结果表明口服异维A酸治疗可减轻抑郁症状。抑郁的改善与痤疮相关生活质量的改善直接相关，而不是与痤疮分级的改善相关。
