Isotretinoin was not associated with depression or anxiety: A twelve-week study

Table 1 Demographic features

Isotretinoine (n = 36)		Other treatments (n = 24)
Gender [n (%)]1
Females	Males	Females	Males
16 (44.4)	20 (55.6)	11 (45.8)	13 (54.2)
Age (mean ± SD)2
23.0 ± 3.2	20.3 ± 2.9	22.9 ± 3.8	23.4 ± 4.4
Marital status [n (%)]3
Single	Others	Single	Others
34 (94.4)	2 (5.6)	15 (62.5)	9 (37.5)
Education [n (%)]4
College	Others	College	Others
6 (16.6)	35 (83.4)	4 (16.7)	(83.3)

¹χ² (1) = 0.01, P = 0.9;

²F (3) = 2.9, P = 0.04; post-hoc Tukey HSD test = 0.07;

³χ² (1) = 7.8, P = 0.005;

⁴χ² (1) = 0.00, P = 1.

Table 2 Frequency of depression and anxiety according to the Zung scales at baseline and during treatment

ITT				OT
Categorical level of depression [n (%)]1
	Basal	Week 6	Week 12	Basal	Week 6	Week 12
Mild	1 (2.8)	3 (8.3)	3 (8.3)	2 (8.3)	2 (8.3)	2 (8.3)
Moderate	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)
Severe	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)	0 (0.0)
Total	1 (2.8)	3 (8.3)	3 (8.3)	2 (8.3)	2 (8.3)	2 (8.3)
Categorical level of anxiety [n (%)]2
	Basal	Week 6	Week 12	Basal	Week 6	Week 12
Mild	1 (2.8)	2 (5.5)	1 (2.8)	1 (4.2)	0 (0.0)	0 (0.0)
Moderate	0 (0.0)	1 (2.8)	2 (5.5)	0 (0.0)	0 (0.0)	0 (0.0)
Severe	0 (0.0)	0 (0.0)	1 (2.8)	0 (0.0)	0 (0.0)	1 (4.2)
Total	1 (2.8)	3 (8.3)	4 (11.1)	1 (4.2)	0 (0.0)	1 (4.2)

Values represent number and percentage in parentheses of subjects with depression or anxiety.

¹Within-group comparisons: ITT group: χ² (2) = 1.2, P = 0.5; OT group: χ² (2) = 0.0, P = 1; between-group comparison: χ² (5) = 1.3, P = 0.9;

²Within-group comparisons: ITT group: χ² (2) = 4.6, P = 0.6; OT group: χ² (2) = 4.0, P = 0.4; between-group comparison: χ² (5) = 4.8, P = 0.4. OT: Other treatments; ITT: Isotretinoine.

Table 3 Depression and anxiety levels at baseline and during treatment

ITT				OT
Depression scores
	Basal	Week 6	Week 12	Basal	Week 6	Week 12
GeDep scale1	38.3 ± 2.5	38.1 ± 2.3	36.8 ± 2.3	36.9 ± 3.1	34.9 ± 2.9	34.9 ± 2.9
Zung scale2	35.2 ± 1.3	33.8 ± 1.4	34.2 ± 1.4	34.9 ± 1.6	34.6 ± 1.7	35.0 ± 1.7
Anxiety scores
	Basal	Week 6	Week 12	Basal	Week 6	Week 12
GegDep scale3	43.3 ± 2.4	41.9 ± 2.3	40.8 ± 2.3	40.9 ± 2.9	38.1 ± 2.9	36.8 ± 2.9
Zung scale4	37.2 ± 1.1	36.7 ± 1.4	36.6 ± 1.6	34.5 ± 1.4	32.4 ± 1.7	32.8 ± 1.9

Values represent mean ± SD scores in the depression and anxiety scales.

¹Within-subject effect: F (2) = 0.5, P = 0.6; between-subject effect: F (1) = 0.3, P = 0.6;

²Within-subject effect: F (2) = 0.6, P = 0.6; between-subject effect: F (1) = 0.6, P = 0.5;

³Within-subject effect: F (2) = 0.5, P = 0.6; between-subject effect: F (1) = 0.9, P = 0.4;

⁴Within-subject effect: F (2) = 0.8, P = 0.5; between-subject effect: F (1) = 3.1, P = 0.09. OT: Other treatments; ITT: Isotretinoine.

Table 4 Correlation matrix between the physician assessment of the acne severity at baseline and the depression and anxiety scores before and during treatment

Treatment group		Depression score (baseline)	Depression score (week 6)	Depression score (week 12)	Anxiety score (baseline)	Anxiety score (week 6)	Anxiety score (week 12)
ITT	PAB vs	0.1 (0.4)	0.08 (0.6)	0.02 (0.9)	0.1 (0.5)	0.1 (0.4)	0.05 (0.8)
OT	PAB vs	0.48 (0.01)1	0.5 (0.01)1	0.5 (0.01)1	0.25 (0.2)	0.39 (0.054)	0.37 (0.07)

PAB: Physician assessment of acne severity at baseline with a scale ranging from minimal = 0 to very severe = 5. Values are the Pearson correlation coefficient and its associated probability in parentheses.

¹Significant association. OT: Other treatments; ITT: Isotretinoine.

Table 5 Correlation matrix of the patient and physician assessments of the acne severity change and the depression and anxiety scores during treatment

Treatment group		Depression score(week 6)	Depression score(week 12)	Anxiety score(week 6)	Anxiety score(week 12)
ITT	Patient evaluation vs	-0.31 (0.067)	-0.43 (0.009)1	-0.43 (0.01)1	-0.38 (0.02)1
	Physician evaluation vs	-0.28 (0.1)	-0.33 (0.049)1	-0.35 (0.03)1	-0.32 (0.057)
OT	Patient evaluation vs	-0.1 (0.6)	-0.-08 (0.7)	-0.3 (0.9)	0.25 (0.2)
	Physician evaluation vs	-0.15 (0.5)	-0.18 (0.4)	-0.03 (0.9)	-0.08 (0.7)

The assessment in acne severity change was conducted with a Likert-type scale ranging from severely worst = 1 to very much improved = 7. Values are the Pearson correlation coefficient and its associated probability in parentheses.

¹Significant association. OT: Other treatments; ITT: Isotretinoine.

Table 6 Demographic and clinical features of the subjects who developed clinically significant depression or anxiety

Treatment	Age (yr)	Gender	Personal history of depression	Personal history of anxiety	Diagnosis before treatment (categorical Zung scales)	Diagnosis during treatment (categorical Zung scales)
ITT	18	M	Yes	Yes	-	Anxiety
ITT	28	M	No	Yes	Anxiety and depression	Anxiety and depression
ITT	25	F	No	No	-	Anxiety and depression
ITT	23	F	Yes	No	-	Anxiety
ITT	23	F	No	No	Depression	Depression
OT	18	M	Yes	Yes	Anxiety and depression	Anxiety and depression
OT	24	M	Yes	No	Depression	Depression

ITT: Isotretinoin; OT: Other treatments; F: Female; M: Male.