title: Screening for depression in adult acne vulgaris patients: tools for the dermatologist.
abstract: BACKGROUND
  Adult dermatological out patients have a 40% prevalence of psychiatric co-morbidity. If psychiatric co-morbidity is unrecognized, undetected and untreated, the consequences may be fatal. Acne is the most common skin disorder of the second and third decades of life. Acne and its treatments may cause depression.
  
  
  OBJECTIVE
  To identify a screening tool to identify depression in adult acne patients.
  
  
  METHODS
  The literature was reviewed to identify validated screening instruments for depressive disorders. Questionnaires studied included the Hospital Anxiety and Depression Scale (HAD), the Brief Patient Health Questionnaire (B-PHQ), the General Health Questionnaire-12 item version (GHQ-12), and the World Health Organization-5 Well Being Index (WHO-5).
  
  
  RESULTS
  WHO-5 performed best in terms of sensitivity (0.93 for a cut-off score of 13) as well as taking least time to complete (2-5 min) and evaluate (0.5-2 min).
  
  
  CONCLUSIONS
  WHO-5 can be recommended as part of a two-step screening process for depression in acne patients. Step 1 is the WHO-5. In the case of a positive score, step 2 is a detailed psychosocial assessment.
authors.affiliation: Department of Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany. verena.henkel@psy.med.uni-muenchen.de
authors.forename: Verena
authors.initials: V
authors.lastname: Henkel
authors.forename: Matthias
authors.initials: M
authors.lastname: Moehrenschlager
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hegerl
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Moeller
authors.forename: Johannes
authors.initials: J
authors.lastname: Ring
authors.forename: Wolf-Ingo
authors.initials: WI
authors.lastname: Worret
mesh_terms: D000152:Acne Vulgaris / Q000150:complications*; D003863:Depression / Q000175:diagnosis* / Q000209:etiology*; D003880:Dermatology / Q000379:methods; D006801:Humans; D011795:Surveys and Questionnaires