title: Female gender and acne disease are jointly and independently associated with the risk of major depression and suicide: a national population-based study.
abstract: Acne is a common disease in adolescence with female preponderance. It could cause poor self-esteem and social phobia. Previous studies based on questionnaires from several thousands of adolescents showed that acne is associated with major depression and suicide. However, the gender- and age-specific risk of depression and suicide in patients with acne remain largely unknown. Using a database from the National Health Insurance, which included 98% of the population of Taiwan in 2006, we identified patients of acne, major depression, and suicide based on ICD-9-CM codes. Totally 47111 patients with acne were identified (16568 males and 30543 females) from 1 million subjects. The youths of 7-12 years had the highest prevalence of acne (14.39%). Major depression was more common in those with acne (0.77%) than controls (0.56% , P < 0.0001) regardless of gender. Multiple logistic regression showed an increased risk of major depression in women without acne (OR = 1.85, 95% CI 1.75-1.96). The risk is additive in women with acne (OR = 2.78, 95% CI 2.43-3.17). Similar additive risk of suicide was noticed in women with acne. In conclusion, acne and gender, independently and jointly, are associated with major depression and suicide. Special medical support should be warranted in females with acne for the risk of major depression and suicide.
authors.affiliation: Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan ; Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Taoyuan 33302, Taiwan.
authors.forename: Yi-Chien
authors.initials: YC
authors.lastname: Yang
authors.affiliation: Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan.
authors.forename: Hung-Pin
authors.initials: HP
authors.lastname: Tu
authors.affiliation: Department of Dermatology, Kaohsiung Veterans General Hospital and National Yang Ming University Hospital, Kaohsiung 81362, Taiwan.
authors.forename: Chien-Hui
authors.identifier: 0000-0002-5118-620X
authors.initials: CH
authors.lastname: Hong
authors.affiliation: Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei 10478, Taiwan ; Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 10478, Taiwan.
authors.forename: Wei-Chao
authors.initials: WC
authors.lastname: Chang
authors.affiliation: Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Taoyuan 33302, Taiwan ; Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Fu
authors.affiliation: Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
authors.forename: Ji-Chen
authors.initials: JC
authors.lastname: Ho
authors.affiliation: Department of Healthcare Management, Yuanpei University, Hsinchu 30015, Taiwan.
authors.forename: Wei-Pin
authors.initials: WP
authors.lastname: Chang
authors.affiliation: Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan ; Department of Public Health, Kaohsiung Medical University, Kaohsiung 80756, Taiwan.
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chuang
authors.affiliation: Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000152:Acne Vulgaris / Q000150:complications* / Q000453:epidemiology*; D000293:Adolescent; D003865:Major Depressive Disorder / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology