Multidimensional assessment of acne vulgaris: links between psychiatric symptoms, disordered eating, and dermatologic...

Acne vulgaris is a common chronic inflammatory skin disease that extends beyond dermatologic symptoms to include psychosocial and behavioral consequences. Although the psychological impact of acne has been acknowledged, the interplay between psychiatric symptoms, eating behaviors, and quality of life remains underexplored.

To evaluate the associations between psychiatric symptoms, eating behavior patterns, and quality of life among patients with acne vulgaris compared to healthy controls.

This case-control study included 120 patients with acne vulgaris and 100 sex-matched controls, age-adjusted in the analyses. Dermatologic assessment included the Global Acne Grading System (GAGS), acne scar characteristics, and the Turkish Acne Quality of Life (TAQoL) questionnaire. Psychiatric and behavioral evaluations included the Brief Psychiatric Rating Scale (BPRS), the Eating Attitudes Test (EAT), the Beck Depression and Anxiety Inventories, Night Eating Syndrome parameters, and the Eating Disorder Examination Questionnaire Turkish Short Form-13 item (EDE-Q-13). Statistical analyses were performed using SPSS 25.0, applying Mann-Whitney U, Pearson chi-square, logistic regression, and partial correlation tests with Benjamini-Hochberg correction. Significance was set at p < 0.05.

Patients with acne were predominantly female (80.0%) and significantly younger than controls (median age, 20 vs. 24 years, p < 0.001). A family history of acne was the strongest correlate of acne case status, a (OR = 5.5, 95% CI: 2.4-13.1, p < 0.001), with several familial cases increasing the risk up to 23-fold. Compared with controls, acne patients had significantly higher scores for psychiatric symptoms (BPRS, p < 0.001), depressive (p < 0.001), and anxiety symptoms (p < 0.001), and disordered eating (EAT, p = 0.001). Logistic regression identified binge-eating behavior (as measured by the EDE-Q-13 subscale) as an independent correlate of acne case status, with a higher odds ratio for acne cases (OR = 2.4, p < 0.001). Partial correlation analyses revealed that depression (r = 0.25, p = 0.008), anxiety (r = 0.29, p = 0.002), binge eating (r = 0.23, p = 0.013), and body dissatisfaction (r = 0.25, p = 0.009) were all positively correlated with poorer acne quality of life-night eating duration associated with the extent of trunk involvement (r = 0.20, p = 0.038).

Acne vulgaris was associated with psychiatric distress, disordered eating, and impaired quality of life in this case-control sample. These findings support a broader psychosocial perspective, but causal inferences cannot be drawn from this cross-sectional design.