Screening for depression in adult acne vulgaris patients: Tools for the dermatologist

BACKGROUND: Adult dermatological out patients have a 40% prevalence of psychiatric co-morbidity. If psychiatric co-morbidity is unrecognized, undetected and untreated, the consequences may be fatal. Acne is the most common skin disorder of the second and third decades of life. Acne and its treatments may cause depression. AIMS: To identify a screening tool to identify depression in adult acne patients. METHODS: The literature was reviewed to identify validated screening instruments for depressive disorders. Questionnaires studied included the Hospital Anxiety and Depression Scale (HAD), the Brief Patient Health Questionnaire (B-PHQ), the General Health Questionnaire-12 item version (GHQ-12), and the World Health Organization-5 Well Being Index (WHO-5). RESULTS: WHO-5 performed best in terms of sensitivity (0.93 for a cut-off score of 13) as well as taking least time to complete (2-5 min) and evaluate (0.5-2 min). CONCLUSIONS: WHO-5 can be recommended as part of a two-step screening process for depression in acne patients. Step 1 is the WHO-5. In the case of a positive score, step 2 is a detailed psychosocial assessment.