AUTHOR=Liu Lin , Xue Yuzhou , Chen Yangmei , Chen Tingqiao , Zhong Judan , Shao Xinyi , Chen Jin 

TITLE=Acne and risk of mental disorders: A two-sample Mendelian randomization study based on large genome-wide association data

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1156522

DOI=10.3389/fpubh.2023.1156522

ISSN=2296-2565

ABSTRACT=<sec><title>Background</title><p>Despite a growing body of evidence that acne impacts mental disorders, the actual causality has not been established for the possible presence of recall bias and confounders in observational studies.</p></sec><sec><title>Methods</title><p>We performed a two-sample Mendelian randomization (MR) analysis to evaluate the effect of acne on the risk of six common mental disorders, i.e., depression, anxiety, schizophrenia, obsessive–compulsive disorder (OCD), bipolar disorder, and post-traumatic stress disorder (PTSD). We acquired genetic instruments for assessing acne from the largest genome-wide association study (GWAS) of acne (<italic>N</italic> = 615,396) and collected summary statistics from the largest available GWAS for depression (<italic>N</italic> = 500,199), anxiety (<italic>N</italic> = 17,310), schizophrenia (<italic>N</italic> = 130,644), OCD (<italic>N</italic> = 9,725), bipolar disorder (<italic>N</italic> = 413,466), and PTSD (<italic>N</italic> = 174,659). Next, we performed the two-sample MR analysis using four methods: inverse-variance weighted method, MR-Egger, weighted median, and MR pleiotropy residual sum and outliers. Sensitivity analysis was also performed for heterogeneity and pleiotropy tests.</p></sec><sec><title>Results</title><p>There was no evidence of a causal impact of acne on the risk of depression [odds ratio (OR): 1.002, <italic>p</italic> = 0.874], anxiety (OR: 0.961, <italic>p</italic> = 0.49), OCD (OR: 0.979, <italic>p</italic> = 0.741), bipolar disorder (OR: 0.972, <italic>p</italic> = 0.261), and PTSD (OR: 1.054, <italic>p</italic> = 0.069). Moreover, a mild protective effect of acne against schizophrenia was observed (OR: 0.944; <italic>p</italic> = 0.033).</p></sec><sec><title>Conclusion</title><p>The increased prevalence of mental disorders observed in patients with acne in clinical practice was caused by modifiable factors, and was not a direct outcome of acne. Therefore, strategies targeting the elimination of potential factors and minimization of the occurrence of adverse mental events in acne should be implemented.</p></sec>