Bella Suarez, Ana Serrano, Department of Psychiatry, Los Andes University Medical School, Mérida 5101, Venezuela.
World J Psychiatry. 2016 Mar 22;6(1):136-42. doi: 10.5498/wjp.v6.i1.136.
To investigate the frequency and severity of depression and/or anxiety in isotretinoin (ITT)-treated subjects and in a non-ITT control group.
Sixty consecutively-admitted non-psychiatric outpatients with acne were assigned to either ITT at a fixed dose of 30 mg/d (n = 36) or "other treatment" group (OT; n = 24). The Zung depression or anxiety scales (with cut-off points), two locally developed scales for depression (GeDepr) and anxiety (Ansilet) (without cut-off points) and clinical global impression scales of acne severity were administered at baseline and at weeks 6 and 12 of treatment. Data was analyzed with the chi-squared test and covariance analysis.
Gender distribution, age, marital status and education level did not differ between both treatment groups. The frequency of depression, as defined by the Zung scale cut-off points was similar in the ITT and in the non-ITT groups: Weeks 6 and 12: 8.3% in both groups, P = 0.9. The frequency of anxiety was similar in the groups as well: Week 6: ITT = 8.3%; OT = 0.0%, P > 0.05; week 12: ITT = 11.1%, OT = 4.2%, P > 0.05. The scores in both scales' sets did not differ between the treatment groups at any evaluation time point (P > 0.05). Five ITT-treated subjects (13.8%) and two from the OT-treated group (8.3%) developed clinically significant anxiety and/or depression during treatment (P > 0.05).
Our study confirms the safety of ITT regarding psychological side effects in regular dermatological patients. Susceptible subjects may exist but their identification requires additional strategies.
调查异维 A 酸(ITT)治疗组和非 ITT 对照组患者抑郁和/或焦虑的频率和严重程度。
连续纳入 60 名非精神科门诊痤疮患者,分别接受 ITT(固定剂量 30mg/d,n=36)或“其他治疗”组(OT;n=24)。基线时、治疗第 6 周和第 12 周分别使用 Zung 抑郁或焦虑量表(分界值)、两个本地开发的抑郁量表(GeDepr)和焦虑量表(Ansilet)(无分界值)以及痤疮严重程度的临床总体印象量表进行评估。采用卡方检验和协方差分析进行数据分析。
两组患者的性别分布、年龄、婚姻状况和教育程度无差异。ITT 和非 ITT 组 Zung 量表分界值定义的抑郁发生率相似:第 6 周和第 12 周均为 8.3%,P=0.9。两组焦虑发生率也相似:第 6 周:ITT=8.3%;OT=0.0%,P>0.05;第 12 周:ITT=11.1%;OT=4.2%,P>0.05。两组在任何评估时间点的两套量表评分均无差异(P>0.05)。治疗期间,5 名 ITT 治疗患者(13.8%)和 2 名 OT 治疗患者(8.3%)出现临床显著的焦虑和/或抑郁(P>0.05)。
本研究证实 ITT 在常规皮肤科患者中使用时不会产生心理副作用。可能存在易感性患者,但需要采用其他策略来识别。