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Abstract SUMMARY Acne vulgaris is the most common skin disease during adolescence and early adulthood. It affects about 85 percent of adolescents. Because of its high visibility, chronicity, and associated disfigurements, it can alter the psychosocial functioning of those who suffer it. This study was aimed at assessing the psychosocial problems of university students having acne vulgaris. Immediate targets to reach such aim were to assess anxiety, depression, body image, self-esteem and social interaction. It was hypothesized that university students with acne have impairment in self-image and social interaction, and that they have more anxiety and tendency for depression. The study was conducted in four faculties. These were chosen randomly from about 16 faculties of Mansoura University. A case-control design was used, with a case group (Acne), and a control group. The case group consisted of 156 students with different grades acne vulgaris, age from 17-21 years, both sexes, with no history of physical, social, educational or psychiatric problems. The control group included 151 students having the same criteria as the acne group, except for being free from acne. The tools used for data collection included: A socio-demographic data questionnaire: covered age, gender, social status, residence, faculty, grade, and for exclusion of physical, social, educational and psychiatric problems. It also included disease characteristics for patients with acne such as duration, course, severity, and treatments. Body image scale: to assess body image among acne and control groups. Self-esteem scale: to assess the self by the self, among acne and control groups. Social interaction questionnaire: developed by researcher based on literature to assess social interaction among acne and control groups. Anxiety scale: to assess anxiety traits and presence of anxiety among acne and control groups. Depression scale: to assess depression levels among acne and control groups. A pilot study was carried out on 10% of the sample to test the applicability, feasibility, and practicability of the tools. It also helped to determine the sample size. The tools were finalized according to the results of the pilot. The main study results revealed the following. Statistically significant relations were revealed between Acne and marital status (p=0.01), and residence (p<0.001) of students. Acne students were more single (81.4%), and from rural areas, 61.5% Students affected with acne have significant impairment in their body image, social interaction and self-esteem, which are higher than those in the control group, p<0.001 Students with acne experienced more severe depression, compared to those in the control group, p<0.001. With increased severity of the disease (Acne), there was a statistically significant increase in the severity of depression (p=0.008), and also more decline in positive body image (p=0.01), and social interaction (p=0.02). With a more progressive course of acne, there was a statistically significant increase in the severity of depression (p=0.01), and also more decline in positive body image (p=0.008), and social interaction (p=0.007). Students who extract their comedones were having statistically significantly lower positive perception of self-esteem. The psychosocial problems of acne had no relation with its duration or its distribution The psychosocial problems of acne were found to be equal in male and female students About half of the students with acne from health-related faculties had severe depression (46.7%), compared to only 17.0% of those from non health-related faculties, (p=0.04). Therefore, it was recommended that healthcare providers should look at acne vulgaris as a real health problem with possible consequent psychosocial problems, and must be aware of the psychosocial consequences of acne. Nurses in students clinics should provide health teaching about care of acne, the importance of continuity of treatment, and psychological care and coping strategies. Psychiatric liaison nurse should be present in dermatology outpatient clinics, and in the clinics of different faculties to assist students. Further research about the relation between psychosocial impact of acne and personality traits, and a prospective longitudinal cohort study for evaluating the incidence and investigating the potential causes of psychosocial dysfunction in acne patients are suggested. |