title: Isotretinoin treatment for acne and risk of depression: A systematic review and meta-analysis.
abstract: BACKGROUND
  The relationship between isotretinoin treatment for acne and depression is controversial. Quantitative analysis has not yet been conducted.
  
  
  OBJECTIVE
  To conduct a meta-analysis, evidence-based examination of the relationship between isotretinoin and depression.
  
  
  METHODS
  A systematic review and meta-analysis of the literature published from inception to September 30, 2016, was conducted. Controlled or prospective non-controlled trials on ≥15 acne patients receiving isotretinoin treatment were included. The prevalence of depression and change in depression scores were calculated.
  
  
  RESULTS
  Thirty-one studies met the inclusion criteria. In the controlled studies, the change in depression scores from baseline was not significantly different between patients receiving isotretinoin treatment and those receiving an alternative treatment (standardized mean difference [SMD] -0.334, 95% confidence interval [CI] -0.680 to 0.011). The prevalence of depression after isotretinoin treatment significantly declined (relative risk [RR] 0.588, 95% CI 0.382-0.904). The mean depression scores significantly decreased from baseline (SMD -0.335, 95% CI -0.498 to -0.172).
  
  
  CONCLUSIONS
  No randomized controlled trials were reviewed; a large inter-study variation was observed.
  
  
  CONCLUSIONS
  Isotretinoin treatment for acne does not appear to be associated with an increased risk for depression. Moreover, the treatment of acne appears to ameliorate depressive symptoms.
authors.affiliation: Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Dermatology, School of Medicine and College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: dhist2002@yahoo.com.tw.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Department of Psychiatry, Cardinal Tien Hospital, New Taipei City, Taiwan; Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Ying-Chih
authors.initials: YC
authors.lastname: Cheng
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D003863:Depression / Q000139:chemically induced* / Q000453:epidemiology; D003879:Dermatologic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D015995:Prevalence; D018570:Risk Assessment
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin
keywords: acne; depression; isotretinoin; meta-analysis; psychological impact; systemic review