Individuals who suffer from severe acne are at an increased risk of attempting suicide, according to a new study from Karolinska Institute. The study also finds that an additional risk may be present during and up to one year after treatment with isotretinoin, a commonly prescribed drug for severe acne. However, the authors stress that this additional risk is most likely due to the acne itself, rather than the drug treatment.
Acne can have severe psychological effects. Most of us, at some stage of our lives, will get the odd spot. But for others it can be more problematic. In fact, for those who suffer from acne it can mean years of feeling self-conscious or inferior.
Isotretinoin (commonly marketed as Roaccutane, Accutane, Amnesteem, Claravis, Clarus or Decutan) has been used to treat severe acne since the 1980s. The treatment can be effective but there have been reports linking isotretinoin to depression and suicidal behaviour. However studies have had conflicting results, say the authors of the current study, which is published online in British Journal of Medicine (BMJ)
With the hypothesis that acne sufferers are at a higher risk of suicide, regardless of whether they are on isotretinoin, Dr Anders Sundstrom and colleagues at Karolinska Institutet, investigated suicide attempts before, during and after isotretinoin treatment for severe acne. The authors assessed the data of individuals who had been prescribed isotretinoin from 1980 to 1989 and linked these to hospital discharge and cause of death registers from 1980 to 2001.
The data of 5,756 individuals were reviewed and 3,613 (63%) of them were male. The average age of men when they were first prescribed isotretinoin was 22 years and women were 27. The results show that 128 patients were admitted to hospital following a suicide attempt. The authors also found that between one and three years before starting isotretinoin treatment the number of suicide attempts increased. However the risks were highest within six months after treatment ended.
The study was funded mainly by the Medical Products Agency in Sweden. Some funding has also been provided by the Swedish Research Council. The participating scientists have collaborated within the framework of the Centre for Pharmacoepidemiology at Karolinska Institutet.
Source: Karolinska Institute Anders Sundström, Lars Alfredsson, Gunilla Sjölin-Forsberg, Barbro Gerdén, Ulf Bergman, Jussi Jokinen
Association of suicide attempts with acne and treatment with isotretinoin: retrospective Swedish cohort study
BMJ online 12 November 2010, doi=10.1136/bmj.c5812 role=elps
