{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T08:41:43Z","timestamp":1790412103751,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T00:00:00Z","timestamp":1574208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007543","name":"Agence Nationale de S\u00e9curit\u00e9 du M\u00e9dicament et des Produits de Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although the causal role of isotretinoin in suicidal behaviour is controversial, suicide attempts (<jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>) do occur among patients taking isotretinoin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe patient profiles and the management of isotretinoin among patients who committed or attempted suicide under treatment. To assess the risk factors for <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content> under isotretinoin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a comprehensive case series of suicides and <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>s under isotretinoin, and a case\u2013control study, using Nationwide French Health Insurance database. The main analysis compared cases (subjects with a <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content> during a course of isotretinoin) to controls, individually matched for age, gender and rank of the current course; controls were to be exposed to isotretinoin at the index date (date of <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content> for the corresponding cases). The patients\u2019 psychiatric history at isotretinoin initiation was studied. In a secondary analysis, patients who continued their isotretinoin treatment after their <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content> were compared to patients who discontinued it.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 328\u00a0018 subjects started a course of isotretinoin between 1 January 2010 and 31 December 2014 and 184 patients were hospitalized for a <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>; half of them had a psychiatric history at initiation. In the multivariate analysis, psychiatric history and history of anxiety alone were risk factors for <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content> [Odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>), 18.21; 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>), 9.96\u201333.30 and 4.78; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 2.44\u20139.33, respectively]. Among 176 cases of <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content> with sufficient follow\u2010up, 103 (58.5%) carried on with their treatment after their <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>. Treatment initiation by a dermatologist was inversely associated with the continuation of the treatment after a <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.38; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.18\u20130.80).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Suicide attempts under isotretinoin are rare events, and our results suggest that most of the patients concerned have a risk\u2010prone profile detectable at the time of treatment initiation. The risk\u2013benefit ratio of continuing isotretinoin after a <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content> warrants further careful evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.16005","type":"journal-article","created":{"date-parts":[[2019,10,6]],"date-time":"2019-10-06T08:49:51Z","timestamp":1570351791000},"page":"1293-1301","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Isotretinoin and risk factors for suicide attempt: a\u00a0population\u2010based comprehensive case series and nested case\u2013control study using 2010\u20132014 French Health Insurance Data"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6714-6643","authenticated-orcid":false,"given":"C.","family":"Droitcourt","sequence":"first","affiliation":[{"name":"Department of Dermatology CHU Rennes Rennes France"},{"name":"INSERM CIC 1414 Universit\u00e9 de Rennes Rennes 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