title: Isotretinoin therapy and mood changes in adolescents with moderate to severe acne: a cohort study.
abstract: OBJECTIVE
  To determine whether patients with moderate to severe acne who were treated with isotretinoin experienced significant increases in depressive symptoms over a 3- to 4-month period compared with patients who received conservative acne therapy.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Hospital-affiliated and community-based clinics in St Louis, Mo.
  
  
  METHODS
  One hundred thirty-two subjects aged 12 to 19 years with moderate to severe acne.
  
  
  METHODS
  Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D), a standardized self-reported instrument. Mean CES-D scores were compared between treatment groups, as were the prevalence and incidence of scores suggestive of clinically significant depression (CES-D score >16).
  
  
  RESULTS
  A total of 101 subjects completed the study. At follow-up, CES-D scores (adjusted for baseline CES-D score and sex of patient) suggestive of clinically significant depression were no more prevalent in the isotretinoin group than in the conservative therapy group. Similarly, the incidence (new onset) of depressive symptoms suggestive of clinical significance also was not significantly different between the treatment groups.
  
  
  CONCLUSIONS
  The use of isotretinoin in the treatment of moderate-severe acne in adolescents did not increase symptoms of depression. On the contrary, treatment of acne either with conservative therapy or with isotretinoin was associated with a decrease in depressive symptoms.
authors.affiliation: Department of Dermatology, Saint Louis University Health Sciences Center, St Louis, MO 63141, USA.
authors.forename: Christina Y
authors.initials: CY
authors.lastname: Chia
authors.forename: Whitney
authors.initials: W
authors.lastname: Lane
authors.forename: John
authors.initials: J
authors.lastname: Chibnall
authors.forename: Angel
authors.initials: A
authors.lastname: Allen
authors.forename: Elaine
authors.initials: E
authors.lastname: Siegfried
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000473:pathology; D000293:Adolescent; D015331:Cohort Studies; D003863:Depression / Q000139:chemically induced* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D015474:Isotretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D015474:Isotretinoin