No association between isotretinoin and impulsivity in patients with moderate-to-severe acne vulgaris.

BACKGROUND: Acne vulgaris (AV) is one of the common dermatologic diseases that usually affects people during adolescence. Reports have shown that isotretinoin, the first-line therapy option for moderate-to-severe AV, could lead to mood disturbances and suicidality. Impulsivity is the tendency to act prematurely without foresight and is a significant risk factor for suicidality. This study aimed to test the hypothesis that isotretinoin would lead to an increase in impulsivity. METHODS: Seventeen patients with AV were enrolled. The study was planned as a naturalistic 3-month follow-up study. Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Barratt Impulsiveness Scale (BIS), Go/No-go Task (GNG), and Balloon Analog Risk Task (BART) were administered before and after the isotretinoin treatment. RESULTS: We found a significant improvement in the severity of anxiety (P = 0.015; t = 2.72) and depression symptoms (P = 0.08; t = 3.04) in AV patients at the end of 3 months. Self-report impulsivity characteristics with BIS stayed unchanged (P = 0.434; t = 0.80). Besides, no statistically significant difference was found in behavioral task results associated with response inhibition with GNG (P = 0.52; t = 0.65) and impulsive decision-making with BART (P = 0.842; t = -0.20). However, there was a significant decrease in omission errors, with GNG suggesting improvement in attention domain (P = 0.020; W = 90.0) after the follow-up. CONCLUSIONS: It has been demonstrated that isotretinoin treatment improves the severity of depression, anxiety symptoms, and attention performance in AV patients. However, there was no significant change in patients' impulsivity severity based on self-reports and behavioral performances based on GNG and BART.

Scabies Affects Quality of Life in Correlation with Depression and Anxiety.

INTRODUCTION: Scabies is a highly contagious disease affects many people worldwide each year and a major public health problem. A small number of studies have shown that scabies causes impairment in the quality of life in adult patients. OBJECTIVES: The aims of this study are to assess the impact of scabies on adult patients quality of life (QoL) and evaluate the relationship between depression and anxiety levels and impairment in life quality. METHODS: This cross-sectional study included adult patients diagnosed with scabies in our dermatology outpatient clinic. The effect of scabies on QoL was evaluated by Dermatology Life Quality Index (DLQI), and the levels of depression and anxiety were evaluated by Beck Depression Scale (BDS) and Beck Anxiety Scale (BAS). RESULTS: Totally, 85 patients included to the study. QoL of 72.2% of the patients was moderate to extremely large affected. There was a positive correlation between the duration of the disease, the total DLQI score and the severity of the disease impact on QoL (rs= 0.287, P = 0.01 and rs=0.280, P = 0.008, respectively). A positive correlation was found between the number of treatments received and the total DLQI (rs= 0.223, P = 0.042). There was a positive correlation between BDS and BAS, and total DLQI score (rs=0.448 and P = 0.000; rs=0.456 and P = 0.000, respectively). CONCLUSIONS: Scabies has a moderate to severe effect on QoL. There was a positive correlation between impairment QoL and anxiety and depression scores.

Impulsivity in Depression: Its Relation to Suicidality.

OBJECTIVE: Impulsivity is an important risk for suicidality, which is common in patients with major depressive disorder (MDD). The goal of this study was to examine multiple facets of impulsivity in depressed patients compared with healthy controls and to assess their relationship to suicidality. METHOD: Outpatients diagnosed with MDD using the Structured Clinical Interview for DSM-IV were recruited. Two groups were constituted as "MDD in remission" (n=32) and "MDD" (n=71). The "healthy control" group (n=30) consisted of individuals who had never been diagnosed with any psychiatric disorder. Impulsivity was assessed with the Barratt Impulsivity Scale (BIS), a self-rating measure, and with the following behavioral tasks: Go/No-go Task, Iowa Gambling Task, and Balloon Analogue Risk Task. The scores of the 3 groups (n=133) were compared to evaluate the effect of MDD. The scores were also analyzed and compared in the patients in the 2 MDD groups (n=103) with respect to their current and lifetime suicidality. RESULTS: There was no difference in the 3 groups in task scores, but nonplanning BIS was correlated with the severity of depressive symptoms. Patients with suicidal ideation (SI) had higher BIS total and attention impulsivity scores and more commission errors on the Go/No-go Task, reflecting failure in response inhibition, compared with the patients without SI. CONCLUSIONS: Failure to show differences in impulsivity-related tasks suggests that there might be no relationship between the state of depression and impulsivity. However, these findings confirm that there is an association between SI and response inhibition and the attention facet of impulsivity in depression.

Impulsivity in patients with acne excoriee.

BACKGROUND: Impulsivity is the tendency to make decisions and act quickly without adequate planning and anticipating risks. Impulsivity is among the core symptoms of many psychiatric disorders. In addition, impulsivity can affect the course of various diseases shaped by behaviors. AIMS: This study aimed to evaluate the relationship between the presence of acne excoriee and different impulsivity dimensions. STUDY DESIGN: A case-control study. METHODS: Thirty patients with acne excoriee (AE+) and 30 acne vulgaris patients without excoriated lesions (AE-) enrolled in this study. Impulsivity was evaluated by The Barratt Impulsivity Scale (BIS). In addition, The Beck Anxiety Inventory, The Beck Depression Inventory, and The Skin Picking Scale were applied to assess the clinical characteristics of the participants. RESULTS: AE+ patients had higher non-planning subscale scores of BIS than AE- patients in this study. In addition, the acne-picking severity score determined by The Skin Picking Scale was positively correlated with non-planning subscale scores of BIS. There was no significant difference between the groups regarding the Beck Depression Inventory and Beck Anxiety Inventory. CONCLUSIONS: These results indicate that AE patients have a lack of forethought. In other words, it has been shown that impulsive personality traits, which indicate a lack of planning for the future, may be associated with the acne-picking behavior of the patients.

The role of online consultation requests to personal social media accounts and instant messaging services of dermatologists in occupational burnout: An emerging problem.

BACKGROUND: Burnout affects all physicians, including dermatologists. Long working hours, high workload, and work-related activities outside working hours are common risk factors for burnout that disrupt the work-life balance. This study aimed to evaluate dermatologists' approach to online consultation requests via social media (SM) and instant messaging services (IMS), the psychological effects of these consultations on dermatologists, and their relationship with burnout syndrome. MATERIALS AND METHODS: A cross-sectional, descriptive research was conducted as an online survey using Google Forms. The survey consisted of 55 items and was sent to dermatologists through a closed Facebook group of the Turkish Society of Dermatology. The burnout levels of dermatologists were evaluated using three subscales of the Maslach Burnout Inventory (MBI): emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). RESULTS: Out of the total 270 participants, 268 (99.3%) participants reported using SM and IMS, whereas 263 (98.1%) received personal consultation requests on these applications. Among all IMS, WhatsApp (n=258, 98.1%) was the most common IMS for online consultation requests. Median (IQR) scores for EE, DP, and PA subscales were 18 (11), 6 (5), and 21 (6), respectively. A positive correlation was observed between the frequency of online consultation requests and MBI-EE subscale scores (r = 0.136; 95% CI, 0.013-0.254; p = 0.026). Fatigue (95.1%), anger (66.6%), and unhappiness (45.2%) were among the most common adverse effects of online consultations on dermatologists. CONCLUSION: Online consultation requests to dermatologists' personal IMS and SM accounts can lead to burnout. The current study findings raise the awareness of the risks of burnout among dermatologists. There is an implicit need for further research, mobile apps other than frequently used IMS and SM apps, and regulations to avoid problems related to the consequences of online dermatology consultations through IMS and SM.