Effects of oral isotretinoin treatment for acne vulgaris patients on anger responses and the relationship with temperament

Demir, Esra Yancar; Köse, Özlem Karadağ

doi:10.1590/1806-9282.20230592

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Original Article • Rev. Assoc. Med. Bras. 70 (1) • 2024 • https://doi.org/10.1590/1806-9282.20230592 copy

Effects of oral isotretinoin treatment for acne vulgaris patients on anger responses and the relationship with temperament

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

Isotretinoin is the only medication against all the factors involved in acne vulgaris pathogenesis. The aim of our study was to verify whether patients with acne vulgaris receiving isotretinoin therapy exhibit elevated anger levels and to observe the correlation between age, temperament traits, and anger.

METHODS:

The study group comprised a sum of 100 cases, involving 50 individuals with acne vulgaris-required high-dose retinol therapy and 50 controls who did not start any medication.

RESULTS:

Our study showed that anger levels increased with drug use. A positive correlation between cyclothymic temperament, the anxiety-related behavior subdimension, and the introvert and passive-aggressive subdimension of interpersonal anger reactions has been recognized. In addition, a positive one was observed between hyperthymic temperament and the introvert subdimension, which is one of the anger-related thoughts and interpersonal anger reactions.

CONCLUSION:

This study elucidates anger dimensions such as anger-related thoughts, behaviors, and reactions in individuals who received retinol treatment for acne vulgaris. In addition to anger and its dimensions, temperament was also investigated. Although several studies have investigated the relationship between acne vulgaris and psychiatric symptoms, to the best of our knowledge, no research has been reported in the English-language literature regarding the relationship between anger dimensions and temperament after retinol treatment that might make our study an original and valuable contribution to the literature.

KEYWORDS:
Acne vulgaris; Anger; Isotretinoin; Aggression; Side effects; Temperament

Beginning-Multidimensional Anger Scale		Isotretinoin (n=50)	Control (n=50)	p-value
Thoughts related to anger		79.74±17.68	70.04±12.04	0.002^* * p<0.005.
	Anger-oriented thought	19.26±9.25	18.62±5.94	0.691
	Angry thoughts toward others	20.66±7.81	19.82±6.22	0.553
	Angry thoughts toward themselves	15.68±5.70	15.26±4.37	0.680
	Angry thoughts toward the world	10.70±5.40	10.90±4.74	0.844
Behavior related to anger		69.16±14.76	70.04±12.04	0.745
	Aggressive	27.20±8.66	25.60±8.03	0.340
	Calm	29.78±8.60	31.50±6.77	0.269
	Anxious	12.18±3.22	12.94±2.88	0.217
Interpersonal anger reactions		122.80±37.20	132.68±33.06	0.164
	Revenge	55.28±22.11	58.58±20.95	0.445
	Passive-Aggressive	31.64±9.18	33.18±8.40	0.542
	Introversion	29.70±8.47	31.84±6.95	0.170
	Unconcerned	8.18±3.21	9.08±3.57	0.188
Third month Multidimensional Anger Scale		Isotretinoin (n=50)	Control (n=50)	p-value
Thoughts related to anger		79.06±26.70	70.04±12.04	0.002^* * p<0.005.
	Anger-oriented thought	24.04±8.72	18.62±5.94	0.001^* * p<0.005.
	Angry thoughts toward others	23.78±8.22	19.82±6.22	0.008^* * p<0.005.
	Angry thoughts toward themselves	18.36±6.14	15.26±4.37	0.004^* * p<0.005.
	Angry thoughts toward the world	12.88±5.02	10.90±4.74	0.045^* * p<0.005.
Behavior related to anger		79.74±17.68	70.04±12.04	0.002^* * p<0.005.
	Aggressive	35.40±9.39	25.60±8.03	0.001^* * p<0.005.
	Calm	31.02±9.39	31.50±6.77	0.738
	Anxious	13.32±3.11	12.94±2.88	0.528
Interpersonal anger		145.56±35.29	132.68±33.06	0.063

Multidimensional Anger Scale		Initial (n=50)	Third month (n=50)	p-value
Thoughts related to anger		79.74±17.68	79.06±26.70	0.001^* * p<0.005.
	Anger-oriented thought	19.26±9.25	24.04±8.72	0.001^* * p<0.005.
	Angry thoughts toward others	20.66±7.81	23.78±8.22	0.001^* * p<0.005.
	Angry thoughts toward themselves	15.68±5.70	18.36±6.14	0.001^* * p<0.005.
	Angry thoughts toward the world	10.70±5.40	12.88±5.02	0.001^* * p<0.005.
Behavior related to anger		69.16±14.76	79.74±17.68	0.001^* * p<0.005.
	Aggressive	27.20±8.66	35.40±9.39	0.001^* * p<0.005.
	Calm	29.78±8.60	31.02±7.49	0.009^* * p<0.005.
	Anxious	12.18±3.22	12.26±3.32	0.014^* * p<0.005.
Interpersonal anger reactions		122.80±37.20	145.56±35.29	0.001^* * p<0.005.
	Revenge	55.28±22.11	72.68±20.04	0.001^* * p<0.005.
	Passive-Aggressive	29.64±9.15	31.72±8.71	0.084
	Introversion	29.70±8.47	31.18±7.71	0.078
	Unconcerned	8.18±3.21	9.98±2.23	0.001^* * p<0.005.

Dimension and subdimensions		DepressiveT	CycloT	HyperthymicT	IrrT	AnxiousT
Thoughts related to anger
	r-value	0.307	0.147	0.220	-0.022	0.111
	P-value	0.002	0.146	0.028	0.829	0.271
Anger-oriented thought
	r-value	0.254	0.145	0.189	-0.073	0.098
	P-value	0.011	0.150	0.060	0.473	0.330
Angry thoughts toward others
	r-value	0.283	0.108	0.201	-0.005	0.116
	P-value	0.004	0.286	0.045	0.960	0.251
Angry thoughts toward themselves
	r-value	0.254	0.070	0.204	-0.062	0.068
	P-value	0.011	0.491	0.041	0.542	0.500
Angry thoughts toward the world
	r-value	0.348	0.228	0.221	0.087	0.122
	P-value	0.000	0.022	0.027	0.389	0.226
Interpersonal anger reaction
	r-value	0.120	0.024	0.250	-0.109	0.036
	P-value	0.234	0.816	0.012	0.278	0.723
Aggressive
	r-value	0.017	-0.037	0.284	-0.260	-0.024
	P-value	0.869	0.713	0.004	0.009	0.815
Calm
	r-value	0.147	0.010	0.102	0.078	0.075
	P-value	0.145	0.921	0.311	0.439	0.459
Anxious
	r-value	0.231	0.226	0.132	0.102	0.091
	P-value	0.021	0.024	0.191	0.312	0.370
Behavior related to anger
	r-value	0.179	0.276	0.252	0.106	0.035
	P-value	0.074	0.005	0.012	0.295	0.731
Revenge
	r-value	0.174	0.150	0.190	0.440	0.205
	P-value	0.076	0.129	0.058	<0.001	0.042
Passive-Aggressive
	r-value	0.116	0.348	0.158	0.235	0.165
	P-value	0.250	<0.001	0.116	0.018	0.102
Introversion
	r-value	0.284	0.317	0.209	0.270	0.086
	P-value	0.004	0.001	0.037	0.007	0.395
Unconcerned
	r-value	0.134	-0.034	0.146	0.005	0.004
	P-value	0.185	0.735	0.146	0.964	0.972

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[1] *Corresponding author: edemiryancar@gmail.com