Acne, Depression, and Anxiety Symptoms in Young Adults

Abstract

Elevated risk and prevalence of internalizing symptoms and diagnoses such as Major Depression (MDD) and Generalized Anxiety Disorder (GAD) are documented in patients with acne, but longitudinal studies remain scarce. Moreover, little is known about the moderating role of gender in this relation and few studies have assessed Canadian samples. Evidence also shows that hormonal contraceptives may mitigate internalizing symptoms for women and is a common treatment for acne. This thesis is comprised of two parts: (1) an extensive narrative review that was published in April 2023 in Dermatological Reviews and (2) an empirical longitudinal study. The narrative review highlighted the theoretical foundation and cross-sectional evidence that implicates acne as cross-cultural risk factor for depression, general anxiety, and social anxiety symptoms. The review also considered the role of hormonal contraceptives in this relation for women. The empirical study examined the longitudinal relation between acne, depression, and anxiety symptoms concurrently and across 3 annual time-points in a sample of Canadian young adults aged 21-23 years old. Self-reported severe acne predicted elevated anxiety symptoms at age 22 when controlling for concurrent depression and gender. Self-reported severe acne at age 22 predicted elevated anxiety at age 23 when controlling for prior depression and anxiety symptoms for men only. There was no association between internalizing symptoms and acne for women and hormonal contraceptives did not alter this finding. Our study showed longitudinal support for previous cross-sectional evidence that implicates acne as a risk factor for anxiety symptoms. Men may be more negatively impacted than women over time. Physicians should carefully attend to emerging adult-males with severe acne by screening for anxiety and provide rapid acne treatment to reduce their mental health burden.