Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China.
Front Public Health. 2023 Mar 31;11:1156522. doi: 10.3389/fpubh.2023.1156522. eCollection 2023.
Despite a growing body of evidence that acne impacts mental disorders, the actual causality has not been established for the possible presence of recall bias and confounders in observational studies.
We performed a two-sample Mendelian randomization (MR) analysis to evaluate the effect of acne on the risk of six common mental disorders, i.e., depression, anxiety, schizophrenia, obsessive-compulsive disorder (OCD), bipolar disorder, and post-traumatic stress disorder (PTSD). We acquired genetic instruments for assessing acne from the largest genome-wide association study (GWAS) of acne ( = 615,396) and collected summary statistics from the largest available GWAS for depression ( = 500,199), anxiety ( = 17,310), schizophrenia ( = 130,644), OCD ( = 9,725), bipolar disorder ( = 413,466), and PTSD ( = 174,659). Next, we performed the two-sample MR analysis using four methods: inverse-variance weighted method, MR-Egger, weighted median, and MR pleiotropy residual sum and outliers. Sensitivity analysis was also performed for heterogeneity and pleiotropy tests.
There was no evidence of a causal impact of acne on the risk of depression [odds ratio (OR): 1.002, = 0.874], anxiety (OR: 0.961, = 0.49), OCD (OR: 0.979, = 0.741), bipolar disorder (OR: 0.972, = 0.261), and PTSD (OR: 1.054, = 0.069). Moreover, a mild protective effect of acne against schizophrenia was observed (OR: 0.944; = 0.033).
The increased prevalence of mental disorders observed in patients with acne in clinical practice was caused by modifiable factors, and was not a direct outcome of acne. Therefore, strategies targeting the elimination of potential factors and minimization of the occurrence of adverse mental events in acne should be implemented.
尽管越来越多的证据表明痤疮会影响精神障碍，但在观察性研究中，由于可能存在回忆偏倚和混杂因素，其因果关系尚未确定。
我们进行了两样本孟德尔随机化（MR）分析，以评估痤疮对六种常见精神障碍（即抑郁症、焦虑症、精神分裂症、强迫症、双相情感障碍和创伤后应激障碍）风险的影响。我们从最大的痤疮全基因组关联研究（GWAS）中获取了评估痤疮的遗传工具（ = 615396），并从最大的抑郁症 GWAS 中收集了汇总统计数据（ = 500199），从最大的焦虑症 GWAS 中收集了汇总统计数据（ = 17310），从最大的精神分裂症 GWAS 中收集了汇总统计数据（ = 130644），从最大的强迫症 GWAS 中收集了汇总统计数据（ = 9725），从最大的双相情感障碍 GWAS 中收集了汇总统计数据（ = 413466），从最大的创伤后应激障碍 GWAS 中收集了汇总统计数据（ = 174659）。接下来，我们使用四种方法进行了两样本 MR 分析：逆方差加权法、MR-Egger 法、加权中位数法和 MR 多效性残差和异常值法。还对异质性和多效性检验进行了敏感性分析。
痤疮对抑郁症（比值比[OR]：1.002， = 0.874）、焦虑症（OR：0.961， = 0.49）、强迫症（OR：0.979， = 0.741）、双相情感障碍（OR：0.972， = 0.261）和创伤后应激障碍（OR：1.054， = 0.069）风险没有因果影响。此外，观察到痤疮对精神分裂症有轻微的保护作用（OR：0.944； = 0.033）。
临床实践中痤疮患者中观察到的精神障碍患病率增加是由可改变的因素引起的，而不是痤疮的直接结果。因此，应该实施针对消除潜在因素和最大限度减少痤疮患者不良心理事件发生的策略。
