{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:43:08Z","timestamp":1790667788778,"version":"4.1.0"},"reference-count":55,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"\n Importance<\/jats:title>\n Isotretinoin is hypothesized to contribute to the development of psychiatric disorders, but the epidemiological association and risk factors associated with psychiatric disorders among isotretinoin users remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To clarify the absolute and relative risk and risk factors associated with suicide and psychiatric disorders among isotretinoin users.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n PubMed, Embase, Web of Science, and Scopus were searched from inception until January 24, 2023.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Randomized trials and observational studies were selected if they reported the absolute risk, relative risk, and risk factors for suicide and psychiatric disorders among isotretinoin users.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n \n Relevant data were extracted and risk of bias was evaluated at the study level using the Newcastle-Ottawa Scale. Data were pooled using inverse variance-weighted meta-analyses. Heterogeneity was measured using the\n I<\/jats:italic>\n 2<\/jats:sup>\n statistic, and meta-regression analyses were performed.\n <\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Absolute risk (percentage), relative risks (risk ratios [RR]), and risk factors (RR) of suicide and psychiatric disorders among isotretinoin users.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 25 studies including 1 625 891 participants were included in the review and 24 in the meta-analysis. Among the included studies, participants\u2019 average age ranged from 16 to 38 years, and distribution by sex ranged from 0% to 100% male. The 1-year pooled absolute risk from between 2 and 8 studies of completed suicide, suicide attempt, suicide ideation, and self-harm were each less than 0.5%, while that of depression was 3.83% (95% CI, 2.45-5.93;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200977%) in 11 studies. Isotretinoin users were less likely than nonusers to attempt suicide at 2 years (RR, 0.92; 95% CI, 0.84-1.00;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%), 3 years (RR, 0.86; 95% CI, 0.77-0.95;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%), and 4 years (RR, 0.85; 95% CI, 0.72-1.00;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200923%) following treatment. Isotretinoin was not associated with the risk of all psychiatric disorders (RR,\u20091.08; 95% CI, 0.99-1.19;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%). Study-level meta-regression found that studies with participants of older age reported lower 1-year absolute risk of depression, while those with a higher percentage of male participants reported a higher 1-year absolute risk of completed suicide.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings suggest that at a population level, isotretinoin users do not have increased risk of suicide or psychiatric conditions but may instead have a lower risk of suicide attempts at 2 to 4 years following treatment. While these findings are reassuring, clinicians should continue to practice holistic psychodermatologic care and monitor patients for signs of mental distress during isotretinoin treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2023.4579","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T11:33:19Z","timestamp":1701257599000},"page":"54","source":"Crossref","is-referenced-by-count":52,"title":["Risk of Suicide and Psychiatric Disorders Among Isotretinoin Users"],"prefix":"10.1001","volume":"160","author":[{"given":"Nicole Kye Wen","family":"Tan","sequence":"first","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelina","family":"Tang","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, 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