Anger and acne: implications for quality of life, patient satisfaction and clinical care.
BACKGROUND
Acne is a common skin disorder with a significant psychological and social impact for some people. Little is known about how personality and emotional traits affect acne and its impact on quality of life and treatment. Trait anger (TA), which is related to heart disease and other morbidities, may also affect acne and patients' adjustment to it.


OBJECTIVE
To evaluate the relationship between TA and acne severity, skin-related quality of life, satisfaction with treatment, and adherence to treatment.


METHODS
A sample of 479 individuals with acne completed a survey instrument to assess acne severity, skin care practices, skin-related quality of life, satisfaction with treatment, adherence, TA and demographic variables. Respondents who reported high TA were compared with individuals with low TA on outcome variables. Regression analyses adjusted for covariates and identified the significant predictors of quality of life, satisfaction and adherence.


RESULTS
High TA was unrelated to acne severity (P = 0.2) or frequency of face washing (P = 0.9). Anger was significantly related to both global quality of life (P < 0.001) and skin-related quality of life (P = 0.002) as well as to satisfaction with treatment (P = 0.001) and adherence to treatment advice (P = 0.05) in bivariate analyses. Regression analyses revealed that high TA remained a significant predictor of global (P < 0.001) and skin-related quality of life (P = 0.003) and satisfaction with treatment (P = 0.04), but not adherence to treatment advice (P = 0.8) after controlling for covariates.


CONCLUSIONS
Anger is associated with the quality of patients' lives and with their satisfaction with treatment. Care of acne patients should include attention to anger and other chronic emotional states, quality of life, as well as to clinical severity. Simple guidelines are suggested for how clinicians might approach this important aspect of care.
Rapp
D A
DA
University of North Carolina-Chapel Hill, Biology, Chapel Hill, NC, USA.
Brenes
G A
GA
Feldman
S R
SR
Fleischer
A B
AB
Graham
G F
GF
Dailey
M
M
Rapp
S R
SR
D000152:Acne Vulgaris / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000786:Anger; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D011613:Psychotherapy; D011788:Quality of Life; D012044:Regression Analysis