Acne and psychiatric comorbidities in Lomé (Togo): case-control study

Objectif The aim of this study was to investigate psychiatric comorbidities (depression and anxiety) associated with acne in dermatology in Lomé (Togo). Material and methods We conducted a case-control study between July 2017 and February 2018. Each case was matched to two controls by sex and age (± 5 years). The ECLA grid was used for the clinical evaluation of acne, and the GAD-7 and PHQ-9 questionnaires were used for respective screening of anxiety and depression. Results We recruited, with their consent, 900 subjects including 300 patients and 600 matched to two controls according to sex and age (± 5 years). The mean age of the cases was 23.7±5.7 years and that of the controls was 23.6 ± 6.2 years, with no difference between the two groups (p = 0.9362). The overall severity score for acne according to the ECLA grid ranged from 2 to 28 points. The severity of acne was not correlated with anxiety scores (GAD-7: r = -0.02; p = 0.6724) and depression (PHQ-9: r = 0.11; p = 0.0567). The GAD-7 questionnaire allowed us to note 72 cases of anxiety (24%) among our patients and 37 cases among our controls (6.2%). The mean GAD-7 score in the cases was 6.5±4.9 compared with 2.9±3.8 in the controls (p <0.0001). Similarly, the PHQ-9 questionnaire allowed us to detect 92 cases of depression (30.7%) among our patients and 82 cases of depression among our controls (13.7%). The average of the PHQ 9 score in the cases was 7.2 ± 5.2 versus 4.0 ± 4.7 in the controls (p <0.0001). Conclusion: Depression and anxiety are significantly associated with acne, regardless of severity. It is important to look for them in any patient admitted for acne, for a psychological / psychiatric decision.