title: A comprehensive health impact assessment and determinants of quality of life, health and psychological status in acne patients.
abstract: OBJECTIVE
  Acne adversely affects all aspects of quality of life (QoL). Although many papers assessed acne-specific QoL impairment, there are few data on its impact on general health and psychological status. Apart from acne severity, little is known about determinants of a worse QoL. The aims of this paper were to measure acne impact on QoL, health and psychological status and to analyze the relationship between socio-demographic variables, disease severity and mental status on QoL of acne sufferers.
  
  
  METHODS
  Acne cases were selected from a survey conducted in 2010. The Short-Form 12-Item Health Survey and the Skindex-29 were used to assess health status and QoL. The 12-Items General Health Questionnaire was used to identify individuals at risk for non-psychotic psychiatric disorders (GHQ-positive). Physician (PhGA) and patient global assessments were obtained. We investigated the variables involved in the QoL through a logistic regression analysis.
  
  
  RESULTS
  One hundred ninety-five cases were analyzed. Twenty-six percent were GHQ-positive; acne's impact on health status was worse compared to other chronic diseases. A GHQ-positive status (Skindex-29 overall: OR 2.6; 95% CI 1.20-5.60, P<0.05, functioning: OR 2.5; 95% CI 1.17-5.44, P<0.05, symptoms: OR 3.0; 95% CI 1.36-6.53, P<0.01; emotions: OR 2.55; 95% CI 1.19-5.46, P<0.05) and having a severe/very severe PhGA (Skindex-29 overall: OR 3.4; 95% CI 1.20-10.38, P<0.05) were associated with a poor QoL. Age of onset >25 was linked to being GHQ-positive (OR 2.92; 95% CI 1.2-7.1, P<0.05) controlling for gender, marital status and educational level.
  
  
  CONCLUSIONS
  Acne is not a minor disease in comparison with other chronic conditions. Age of onset is capable to influence GHQ status which in turn affects QoL.
authors.affiliation: Health Services Research Unit, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy - calogero.pagliarello@libero.it.
authors.forename: C
authors.initials: C
authors.lastname: Pagliarello
authors.forename: C
authors.initials: C
authors.lastname: Di Pietro
authors.forename: S
authors.initials: S
authors.lastname: Tabolli
mesh_terms: D000152:Acne Vulgaris / Q000453:epidemiology / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001007:Anxiety / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D004644:Emotions; D005260:Female; D062489:Health Impact Assessment / Q000706:statistics & numerical data; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult