Evidence map›Paper›PMID 38500340›Full record

ArticlePediatric dermatology

The occurrence of mental health symptoms in isotretinoin-treated adolescents.

Keith Miller, Alastair McKean, Jennifer Hand, Sandra Rackley, Jonathan G Leung, Allison LeMahieu, Jennifer Geske, J Michael Bostwick

Open access · greenAbstract read
In one paragraph

Article in Pediatric dermatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.1field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Keith MillerDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-6392-8186
Alastair McKeanDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
Jennifer HandDepartment of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Sandra RackleyDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
Jonathan G LeungDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0003-3836-9375
Allison LeMahieuDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Jennifer GeskeDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
J Michael BostwickDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
Mayo Clinic · USMayo Clinic in Florida · USJacobs Institute · US

Funding

Mayo Clinic Center for Clinical and Translational Science (CCaTS UL1 Supplement - Dr. Timothy Curry)UL1TR002377 · NCATS · MAYO CLINIC ROCHESTER · PI VESNA D GAROVIC · 2017 to 2026
$78.4M
Rochester Epidemiology ProjectR01AG034676 · NIA · MAYO CLINIC ROCHESTER · PI ROCCA, WALTER A, ST SAUVER, JENNIFER LYNN · 2010 to 2019
$9.5M
Interdisciplinary Infrastructure for Aging Research: Rochester Epidemiology ProjectR33AG058738 · NIA · MAYO CLINIC ROCHESTER · PI LEBRASSEUR, NATHAN K, OLSON, JANET E · 2020 to 2022
$2.4M
NCATS NIH HHS UL1 TR002377NCATS NIH HHS UL1TR002377NIA NIH HHS R01 AG034676NIA NIH HHS R01AG034676NIA NIH HHS R33 AG058738NIH HHS
6 · The paper itself

Abstract

backgroundIsotretinoin treatment for acne can reduce adverse psychiatric outcomes in adults, but there has been little investigation of the incidence of psychiatric outcomes in treated adolescents.

methodsThis retrospective cohort study using the Rochester Epidemiology Project identified 606 patients aged 12-18 prescribed isotretinoin over a 10-year period between January 1, 2008 and December 31, 2017. Medical records were reviewed to identify psychiatric diagnoses before and during isotretinoin therapy, as well as psychiatric symptoms not captured by formal diagnoses and changes to isotretinoin dosing because of psychiatric diagnoses or symptoms.

resultsOne hundred seventy-seven (29.2%) had a psychiatric diagnosis prior to isotretinoin initiation, but 98 (16.2%) had a new psychiatric diagnosis or psychiatric symptom while taking isotretinoin. Patients with a psychiatric history were no more likely than those without to receive a new psychiatric diagnosis during treatment (4.5% vs. 3.7%; p = .650), but did experience more psychiatric symptoms, primarily low mood and mood swings (23.7% vs. 7.7%; p < .001). Only 25.5% of the 98 with a new psychiatric diagnosis or psychiatric symptom had a subsequent dose change. A dose change was more likely if patients received a new psychiatric diagnosis (41.7% vs. 20.3%; p = .037) or patients did not have a psychosocial explanation for psychiatric symptoms (34.4% vs. 10.8%; p = .009).

conclusionsA substantial proportion of adolescent patients prescribed isotretinoin had a prior psychiatric diagnosis. This predicts more psychiatric symptoms during isotretinoin treatment. Adolescents with a psychiatric history who have worsening symptoms and those with new-onset psychiatric symptoms would benefit from close monitoring while taking isotretinoin.

Indexed as

Acne VulgarisDermatologic AgentsIsotretinoinMental DisordersAdolescentChildFemaleHumansMaleRetrospective StudiesDermatologic AgentsIsotretinoinadolescentdepressionisotretinoinmental healthsuicide

Identifiers

PMID38500340
PMCPMC11262976
OpenAlexW4392965299

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.