Assessment of Eating Attitude and Psychiatric Parameters in Patients with Acne Vulgaris
Keywords:
Acne vulgaris, Eating attitude, Disordered eating, Depression, Obsessive-Compulsive DisorderAbstract
Introduction: Redundancy of psychological comorbidities in acne vulgaris may contribute to disturbed eating attitude.
Objective: The aim of this study was to investigate possible relation between acne vulgaris and disturbed eating attitude.
Methods: One hundred acne patients and 86 healthy volunteers evaluated by the Symptom Checklist-90 Revised (SCL-90) and possible indicative of disordered eating using the Eating Attitudes Test-40 (EAT-40) and Eating Disorders Examination-Questionnaire (EDEQ).
Results: Mean EAT-40 score was significantly higher in acne group (24.1±17.4) compared to control group (14.2±9.0) (P=0.001). Global score of EDEQ and all subscores were statistically higher in acne group (for each P=0.001). The ratio of participants who meaningful scores for Restraint Eating and Weight Concern subscores of EDEQ was significantly higher in the patient group compared to the control group (P=0.003; P=0.034 respectively). Obsessive-compulsive and Depression subscores of SCL-90-R among acne patients who had meaningful EAT-40 scores were statistically higher compared to those had EAT-40 scores <30 (P=0.030; P=0.006 respectively).
Conclusion: Because of higher mortality and morbidity rates clinicians should screen acne patients for possible disordered eating psychopathology, with particular attention to those with obsessive-compulsive and depression.
References
Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016 May;74(5):945-73.e33. DOI: 10.1016/j.jaad.2015.12.037.
Sood S, Jafferany M, Vinaya Kumar S. Depression, psychiatric comorbidities, and psychosocial implications associated with acne vulgaris. J Cosmet Dermatol. 2020 Dec;19(12):3177-3182. DOI: 10.1111/jocd.13753.
Wu SF, Kinder BN, Trunnell TN, Fulton JE. Role of anxiety and anger in acne patients: a relationship with the severity of the disorder. J Am Acad Dermatol. 1988 Feb;18(2 Pt 1):325-33. DOI: 10.1016/s0190-9622(88)70047-x.
Samuels DV, Rosenthal R, Lin R, Chaudhari S, Natsuaki MN. Acne vulgaris and risk of depression and anxiety: A meta-analytic review. J Am Acad Dermatol. 2020 Aug;83(2):532-541. DOI: 10.1016/j.jaad.2020.02.040.
Lukaviciute L, Ganceviciene R, Navickas P, Navickas A, Grigaitiene J, Zouboulis CC. Anxiety, Depression, and Suicidal Ideation amongst Patients with Facial Dermatoses (Acne, Rosacea, Perioral Dermatitis, and Folliculitis) in Lithuania. Dermatology. 2020;236(4):314-322. DOI: 10.1159/000506627.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; American Psychiatric Association: Arlington, VA, USA, 2013.
Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr. 2019 May 1;109(5):1402-1413. DOI: 10.1093/ajcn/nqy342.
Lee S, Leung CM, Wing YK, Chiu HF, Chen CN. Acne as a risk factor for anorexia nervosa in Chinese. Aust N Z J Psychiatry. 1991 Mar;25(1):134-7. DOI: 10.3109/00048679109077729.
Gupta MA, Gupta AK. Dissatisfaction with skin appearance among patients with eating disorders and non-clinical controls. Br J Dermatol. 2001 Jul;145(1):110-3. DOI: 10.1046/j.1365-2133.2001.04292.x.
Pochi PE, Shalita AR, Strauss JS, et al. Report of the Consensus Conference on Acne Classification. Washington, D.C., March 24 and 25, 1990. J Am Acad Dermatol. 1991 Mar;24(3):495-500. DOI: 10.1016/s0190-9622(08)80076-x.
Lindvall Dahlgren C, Wisting L. Transitioning from DSM-IV to DSM-5: A systematic review of eating disorder prevalence assessment. Int J Eat Disord. 2016 Nov;49(11):975-997. DOI: 10.1002/eat.22596.
Garner DM, Garfinkel PE. The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med. 1979 May;9(2):273-9. DOI: 10.1017/s0033291700030762.
Savaşır I, Erol N. Yeme Tutumu Testi. Anoreksiya nevroza belirtileri indeksi. Psikoloji Dergisi 1989; 7: 19-25.
Derogatis LR, Lipman RS, Covi L. SCL-90: an outpatient psychiatric rating scale--preliminary report. Psychopharmacol Bull. 1973 Jan;9(1):13-28.
Kılıç M. ‘’Belirti Tarama Listesi (SCL-90-R)’nin Geçerlilik ve Güvenilirliği’’. Türk Psikolojik Danışma ve Rehberlik Dergisi 1991; 1: 45-52.
Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994 Dec;16(4):363-70.
Yucel B, Polat A, Ikiz T, Dusgor BP, Elif Yavuz A, Sertel Berk O. The Turkish version of the eating disorder examination questionnaire: reliability and validity in adolescents. Eur Eat Disord Rev. 2011 Nov-Dec;19(6):509-11. DOI: 10.1002/erv.1104.
Mond JM, Hay PJ, Rodgers B, Owen C. Eating Disorder Examination Questionnaire (EDEQ): norms for young adult women. Behav Res Ther. 2006 Jan;44(1):53-62. DOI: 10.1016/j.brat.2004.12.003.
Öner Ü, Hacınecipoğlu F. Could acne be a risk factor for developing eating disorders? Acne vulgaris and eating disorders. J Cosmet Dermatol. 2022 May;21(5):2176-2182. DOI: 10.1111/jocd.14330.
Stice E, Shaw HE. Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. J Psychosom Res. 2002 Nov;53(5):985-93. DOI: 10.1016/s0022-3999(02)00488-9.
Bowe WP, Doyle AK, Crerand CE, Margolis DJ, Shalita AR. Body image disturbance in patients with acne vulgaris. J Clin Aesthet Dermatol. 2011 Jul;4(7):35-41.
Rigopoulos D, Gregoriou S, Ifandi A, et al. Coping with acne: beliefs and perceptions in a sample of secondary school Greek pupils. J Eur Acad Dermatol Venereol. 2007 Jul;21(6):806-10. DOI: 10.1111/j.1468-3083.2006.02091.x.
Marron SE, Miranda-Sivelo A, Tomas-Aragones L, et al. Body dysmorphic disorder in patients with acne: a multicentre study. J Eur Acad Dermatol Venereol. 2020 Feb;34(2):370-376. DOI: 10.1111/jdv.15954.
Lawler M, Nixon E. Body dissatisfaction among adolescent boys and girls: the effects of body mass, peer appearance culture and internalization of appearance ideals. J Youth Adolesc. 2011 Jan;40(1):59-71. DOI: 10.1007/s10964-009-9500-2.
Sneddon J, Sneddon I. Acne excoriée: a protective device. Clin Exp Dermatol. 1983 Jan;8(1):65-8. DOI: 10.1111/j.1365-2230.1983.tb01746.x.
Poli F, Auffret N, Beylot C, et al. Acne as seen by adolescents: results of questionnaire study in 852 French individuals. Acta Derm Venereol. 2011 Sep;91(5):531-6. DOI: 10.2340/00015555-1125.
Karaağaç M, Akça HM, Acat Ö. Lack of Association of Acne Severity with Depression, Anxiety, Stress, and Eating Attitudes: A Cross-Sectional Study. J Pers Med. 2024 Jan 23;14(2):133. DOI: 10.3390/jpm14020133.
Ferreiro F, Seoane G, Senra C. Toward understanding the role of body dissatisfaction in the gender differences in depressive symptoms and disordered eating: a longitudinal study during adolescence. J Adolesc. 2014 Jan;37(1):73-84. DOI: 10.1016/j.adolescence.2013.10.013.
Sarkar S, Patra P, Mridha K, Ghosh SK, Mukhopadhyay A, Thakurta RG. Personality disorders and its association with anxiety and depression among patients of severe acne: A cross-sectional study from Eastern India. Indian J Psychiatry. 2016 Oct-Dec;58(4):378-382. DOI: 10.4103/0019-5545.196720.
Altman SE, Shankman SA. What is the association between obsessive-compulsive disorder and eating disorders? Clin Psychol Rev. 2009 Nov;29(7):638-46. DOI: 10.1016/j.cpr.2009.08.001.
Greenwood EA, Pasch LA, Cedars MI, Huddleston HG. Obesity and depression are risk factors for future eating disorder-related attitudes and behaviors in women with polycystic ovary syndrome. Fertil Steril. 2020 May;113(5):1039-1049. DOI: 10.1016/j.fertnstert.2020.01.016.
Gupta MA, Gupta AK, Ellis CN, Voorhees JJ. Bulimia nervosa and acne may be related: a case report. Can J Psychiatry. 1992 Feb;37(1):58-61. DOI: 10.1177/070674379203700113.
Parry SA, Woods RM, Hodson L, Hulston CJ. A Single Day of Excessive Dietary Fat Intake Reduces Whole-Body Insulin Sensitivity: The Metabolic Consequence of Binge Eating. Nutrients. 2017 Jul 29;9(8):818. DOI: 10.3390/nu9080818.
Hediger C, Rost B, Itin P. Cutaneous manifestations in anorexia nervosa. Schweiz Med Wochenschr. 2000 Apr 22;130(16):565-75.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Hazel Ezgi Kaya, İlknur Kıvanç Altunay, Aslı Aksu
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Dermatology Practical & Conceptual applies a Creative Commons Attribution License (CCAL) to all works we publish (http://creativecommons.org/licenses/by-nc/4.0/). Authors retain the copyright for their published work.
How to Cite
Share
