{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:03:24Z","timestamp":1788185004413,"version":"build-2803163510"},"reference-count":55,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,12,4]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to investigate the association between the use of isotretinoin and the risk of depression in patients with acne.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a meta-analysis in which the standardised mean difference (SMD) and the relative risk (RR) were used for data synthesis employing the random-effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Studies were identified via electronic searches of PubMed, Embase and the Cochrane Library from inception up to 28 December 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients with acne.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Studies comparing isotretinoin with other interventions in patients with acne were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty studies were selected. The analysis of 17 studies showed a significant association of the use of isotretinoin with improved symptoms compared with the baseline before treatment (SMD = \u22120.33, 95% CI \u22120.51 to \u22120.15, p&lt;0.05;<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>=76.6%, p&lt;0.05)). Four studies were related to the analysis of the risk of depression. The pooled data indicated no association of the use of isotretinoin with the risk of depressive disorders (RR=1.15, 95%\u2009CI 0.60 to 2.21, p=0.14). The association of the use of isotretinoin with the risk of depressive disorders was statistically significant on pooling retrospective studies (RR=1.39, 95%\u2009CI 1.05 to 1.84, p=0.02), but this association was not evident on pooling prospective studies (RR=0.85, 95%\u2009CI 0.60 to 2.21, p=0.86).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggested an association of the use of isotretinoin in patients with acne with significantly improved depression symptoms. Future randomised controlled trials are needed to verify the present findings.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-021549","type":"journal-article","created":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T16:45:03Z","timestamp":1548175503000},"page":"e021549","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":75,"title":["Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"9","author":[{"given":"Changqiang","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianmei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Ai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Kuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,1,21]]},"reference":[{"key":"2024051712362955000_9.1.e021549.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60321-8"},{"key":"2024051712362955000_9.1.e021549.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2004.03.002"},{"key":"2024051712362955000_9.1.e021549.3","doi-asserted-by":"publisher","DOI":"10.1159\/000067817"},{"key":"2024051712362955000_9.1.e021549.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp033487"},{"key":"2024051712362955000_9.1.e021549.5","doi-asserted-by":"publisher","DOI":"10.1177\/12034754040080S202"},{"key":"2024051712362955000_9.1.e021549.6","first-page":"92","article-title":"An update on the presence of psychiatric comorbidities in acne patients, Part 2: Depression, anxiety, and suicide","volume":"88","author":"Saitta","year":"2011","journal-title":"Cutis"},{"key":"2024051712362955000_9.1.e021549.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f2634"},{"key":"2024051712362955000_9.1.e021549.8","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200506010-00002"},{"key":"2024051712362955000_9.1.e021549.9","first-page":"780","article-title":"The cost-effectiveness of isotretinoin in the treatment of acne. 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