Objective: Activation of the inflammatory response system may cause depressive symptoms and psychological distress. Therefore, it is important to emphasize the link between the proinflammatory state, psychological distress, and clinical features in acne vulgaris (AV), a chronic inflammatory disease. We aimed to examine psychological distress and systemic inflammatory markers (systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI)) and their relationship with illness-related factors in AV patients to address this potential link.
Method: This study recruited 129 patients with AV without any psychiatric disorder and 60 healthy subjects matched with the patient group regarding age and gender. All participants’ current depressive, anxiety, and stress levels were assessed with the
Depression Anxiety Stress Scale-21 (DASS-21). The severity of acne of the patients was evaluated with Global Acne Scoring System (GASS). SII [neutrophils × platelets/lymphocytes] and SIRI [neutrophils × monocytes/lymphocytes] were calculated through routine blood screenings during the current admission.
Results: DASS-21 Anxiety was significantly higher in the patient group than in controls (t=2.544; p<0.05), while DASS-21 Depression and Stress, SII, and SIRI did not differ between the groups (p>0.05). Duration of illness was positively correlated with
DASS-21 Stress (r=0.30, p<0.001). A multivariate regression model using duration of illness, GASS score, SII, and SIRI revealed that only duration of illness predicted DASS-21 Stress (β=0.31, p<0.05).
Conclusion: Independent of systemic proinflammatory status, psychological distress is associated with the duration of illness in AV patients. Clinicians should be more attentive in monitoring psychological distress in AV patients, particularly those with prolonged illness duration, and be more willing to seek help from a specialist psychiatrist to increase the quality of life of patients with AV.