The mental health burden in acne vulgaris and rosacea: an analysis of the US National Inpatient Sample

Abstract

Summary Background Little is known about the mental health (MH) hospitalization among patients with acne and rosacea. Aims To determine the MH disorders and cost burden associated with acne and rosacea. Methods Data were examined from the 2002–2012 US National Inpatient Sample, comprising a sample of ~20% of all US paediatric and adult hospitalizations (n = 87 053 155 admissions). Results A diagnosis of ≥ 1 MH disorder was much more common among all inpatients with vs. those without a diagnosis of acne (43.7% vs. 20.0%, respectively) and rosacea (35.1% vs. 20.0%, respectively). In multivariable logistic regression models controlling for sex, age, race/ethnicity and insurance status, acne (adjusted OR = 13.02; 95% CI 11.75–14.42) and rosacea (adjusted OR = 1.70; 95% CI 1.56–1.95) were associated with significantly higher odds of a primary admission for an MH disorder (13 and 8, respectively, of 15 MH disorders examined). Both acne and rosacea were associated with higher risk of mood, anxiety, impulse control and personality disorders, and with > $2 million of excess mean annual costs of hospitalization for MH disorders in the USA. Conclusion In this study, inpatients with acne or rosacea had increased odds of comorbid MH disorders. In particular, there was an increased number of hospital admissions secondary to a primary MH disorder with coexistent acne/rosacea. MH comorbidities were associated with considerable excess costs among inpatients with acne or rosacea.

Psychodermatology of acne: Psychological aspects and effects of acne vulgaris

“…Acne relapses were associated with impaired quality of life and productivity loss/absenteeism in 5.7% of the patients in a French study 16 . Severe acne was also associated with mental hospital admission for numerous comorbid disorders, such as anxiety disorders, adjustment disorders, personality disorders, and substance use disorders in 25.3% of acne patients studied by Singam et al 17 In their study, Eroğlu et al 18 reported that 41.3% of adolescent patients with acne have self‐injurious behavior that was associated with low to middle self‐esteem levels and increased subsequent hopelessness and hostility. Interestingly, seven of the studied patients were diagnosed with sexual abuse 18 .…”

Updates on the Risk of Neuropsychiatric and Gastrointestinal Comorbidities in Rosacea and Its Possible Relationship with the Gut–Brain–Skin Axis

“…Female patients with rosacea showed a higher risk of having generalized anxiety disorder (OR: 2.8; 95% CI: 1.15–7.37) than males [ 45 ]. The study examined a US national inpatients sample and found that patients diagnosed with rosacea showed increased odds (OR: 1.70; 95% CI: 1.56–1.95) of a primary admission for mental health disorders [ 46 ]. Treatment for rosacea, particularly for blushing, might help improve depressive symptoms and social anxiety [ 47 ].…”

Systemic Comorbidities in Korean Patients with Rosacea: Results from a Multi-Institutional Case-Control Study

“…Once believed a disorder confined to the skin, now there is mounting evidence linking rosacea with systemic illnesses. In recent studies, rosacea patients were shown to carry greater risk of cardiovascular diseases, allergies, psychiatric problems, gastrointestinal disorders, malignancies, and autoimmune conditions relative to controls without rosacea [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ].…”