This study was designed to evaluate the prevalence of depression, severity of depression, body image disturbances, self- esteem and quality of life in patients of acne scarring.It also aimed to study the correlation of depression with self- esteem, body image disturbances and quality of life in these patients. The following conclusions were drawn from the study – 1. The mean age of the patients was 24.17 + 3.76 years with their ages ranging from 18-30 years. 2. In our study, females (53.08%) slightly predominated as compared to males.(46.91%) 3. In our study, we found that nearly 73 patients (90.12%) were single whereas only 8(9.87%) of the patients were married. This could be due to the fact that presentation of acne vulgaris is in the adolescent age group. 4. On assessing the study population for educational level, 3 (3.70%) of the patients had completed secondary school, 24 (29.62%) of them had completed higher secondary school, and nearly 54 (66.65%) had completed a graduate / post-graduate or professional course. None of the patients in our study sample were illiterate. 5. In our study more than 50% (66.67%) of our patients were working as compared to 32% who were unemployed. 6. On analyzing the family income, we found that 53 (65.43%) of the patients had a monthly family income less than Rs. 12,019, and about 28 (34.56%) had an income up to Rs. 32,049. 7. Most of our patients belonged to lower class (26%) and lower middle class (59%) whereas only 14.8% were from upper middle class. 8. In our study we found the mean duration of acne to be 6.03 ± 2.912 years, whereas the mean duration of acne scar was 2.88 + 1.29 years. 9. In our study, 37(45.67%) patients had grade 1 acne scars, 39 (48.14%) patients had grade 2 acne scars .Only 5(6.17%) patients had grade 3 scars. 10. When our patients were assessed on morphological acne scar grading then nearly 45 % patients had box scars or rolling scars each respectively, ice pick scarring was seen in only 2 patients whereas hypertrophic scarring was seen in 5 patients. 11. 60% patients had less than 50 acne scars whereas 40 % patients had >50 acne scars on their faces. 12. When our patients were assessed for the site of involvement of acne scars then all patients had facial involvement with 24 patients also having other areas involved such as back, arms, chest and shoulders. 13. In our study all our patients had already sought some sort of pharmacological treatment which included topical antibiotics, steroids as well as chemical peels for acne. 24 (29.62%) patients had also undergone surgical intervention for the same which included dermabrasion, skin microneedling, dermal fillers and subcision. Around 38(46.91%) patients also sought ayurvedic remedies for initial acne as well as the scars. In India Ayurveda is followed & hence patients do seek this treatment option along with herbal or home remedies for improvement. 14. When all the patients were assessed on the BDI to find the prevalence of depression we found that the total mean BDI score was 16.81 + 9.708. Thus, more than 1/3rd of our patients were suffering from depressive symptoms which were undiagnosed. On assessing severity of depression as per BDI, clinical depression was reported in total 31(38.27%) patients of whom 9 (11.11%) patients had borderline clinical depression, 15 had moderate depression & 7 patients had severe depression. 36 patients reported mild mood disturbances which did not classify for diagnosis of depression while14 patients had normal mood. 15. When all our patients were assessed for association between severity of depression as per BDI acne scar grading as per qualitative acne scar grading system we found that only 2 patients with borderline clinical depression had grade 3 scarring whereas 7 patients had grade 1scarring. 11patients of moderate depression had grade 1 scarring whereas 4 had grade 2 scarring. 4 patients with severe depression had grade 1 & 3 patients had grade 2 scarring respectively. Majority of our patients had grade 1 / grade 2 scarring only. 16. We also found that out of 31 patients who were clinically depressed as per BDI , 14(17.22%) patients had acne scars more than 50 and 17(20.98%) patients had acne scars less than 50. 17. When the BICI was applied to study the prevalence of body image disturbances in our patients then, 5(6.17%) patients had a score more than 72 which was the cut off score. The total mean BICI score was 46.60 + 15.81. 18. When we studied for self esteem in our sample then all our patients had average self high self esteem in our sample. The total mean RSES score was 20.30 + 3.90. 19. When all patients were assessed for impact of acne on quality of life all reported a very large effect with total mean DLQI score 16.09 + 4.04. 20. On analyzing the study population for correlation of depression as per total BDI score with self esteem (total RSES score), body image (total BICI score), and quality of life (total DLQI Score ) we found a negative correlation between depression & self esteem ( r = -0.3626,p= 0.0009) , positive correlation between depression & body image concern(r=0.4537,p=0.0001),negative correlation between depression & quality of life(r =-0.7204,p=0.0001) .This shows that due to depression there was lower self esteem , more body image concern and impaired quality of life. |