title: Affective disorders as potential complication of anti-acne treatment with isotretinoin: A case series.
abstract: To analyse cases of 9 patients (18-27 yo) who were consequently admitted to our department and treated with affective disorders (AD) while undergoing isotretinoin (INN) therapy.
  
  
  
  A semi-structured questionnaire designed by the authors was used to analyse many variables related to demographic characteristics, dermatologic and psychiatrics symptoms, AD course and treatment, family history of mental disorders, building on medical histories of patients and their families, and available medical records.
  
  
  
  Patients were diagnosed (DSM-IV-TR) with: a major depressive episode (4 patients), a recurrent major depressive episode (3), a bipolar mixed episode (1), and rapid cycling bipolar I disorder (1). The mean time from the first use of INN to: I. the onset of mental disorders was approximately 2 months (1-6 months), II. a visit with a psychiatrist was about 12 months (1-38 months). The predictors of occurrence of AD included a family history of AD and a prior episode of mental disorders. The onset of AD was in most cases preceded by prodromal symptoms such as headaches, sleep disorders, fatigue, drowsiness, or general weakness. Five patients reported suicidal ideation, four patients showed suicidal tendencies, and two persons attempted to commit suicide during the treatment.
  
  
  
  Psychiatrists should pay special attention to isotretinoin as a drug that may trigger episodes of AD, particularly in patients with a family history of AD or prior episodes of mental disorders. Isotretinoin therapy of patients with acne and a family history of AD or prior episodes of mental disorders requires special care and, if symptoms of depression develop or worsen during the INN treatment, collaboration between a dermatologist and a psychiatrist is needed.
authors.affiliation: I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Poland; Department of Clinical Neuropsychiatry, Medical University of Lublin, Poland; Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Poland. Electronic address: hannakarakulajuchnowicz@umlub.pl.
authors.forename: Karakula-Juchnowicz
authors.initials: KJ
authors.lastname: Hanna
authors.affiliation: Department of Psychiatric Nursing, Medical University of Lublin, Poland; Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Poland.
authors.forename: Kowal-Popczak
authors.initials: KP
authors.lastname: Agnieszka
authors.affiliation: I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Poland; Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Poland.
authors.forename: Dzikowski
authors.initials: D
authors.lastname: Michal
authors.affiliation: Department of Psychology, University of Pedagogy in Bialystok, Poland; Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Poland.
authors.forename: Juchnowicz
authors.initials: J
authors.lastname: Dariusz
authors.affiliation: Department of Psychology, University of Pedagogy in Bialystok, Poland; Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Poland.
authors.forename: Dzikowska
authors.initials: D
authors.lastname: Izabela
authors.affiliation: I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Poland; Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Poland.
authors.forename: Makarewicz
authors.initials: M
authors.lastname: Agata
authors.affiliation: Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Poland; II Department of Psychiatry and Psychiatry Rehabilitation, Medical University of Lublin, Poland.
authors.forename: Dubas-Slemp
authors.initials: DS
authors.lastname: Halina
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000523:psychology; D000293:Adolescent; D000328:Adult; D003879:Dermatologic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects*; D008297:Male; D019964:Mood Disorders / Q000139:chemically induced* / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin
keywords: Acne vulgaris; Affective disorders; Bipolar disorder; Depression; Isotretinoin; Suicide attempt