Tesis

Hubungan Derajat Akne Vulgaris dengan Derajat Depresi dan Stres pada Perempuan Dewasa = Correlation between Acne Vulgaris Severity, Depression, and Stress among Adult Female Acne.

Akne vulgaris (AV) merupakan inflamasi kronis folikel pilosebasea yang kerap persisten, umumnya dimulai sejak usia remaja atau muncul baru saat dewasa. AV dipengaruhi hormon, stres, dan gaya hidup, serta berdampak besar pada khususnya kualitas hidup perempuan, karena melibatkan area wajah yang terlihat. Proporsi, derajat depresi dan stres pada perempuan dewasa dengan AV, serta hubungan derajat keparahan depresi dan stres dengan keparahan AV, belum diketahui. Sebanyak 44 orang subjek perempuan dengan AV berusia ≥25 tahun diikutsertakan dalam penelitian potong lintang ini. Calon SP dengan riwayat stressful life events dan gangguan psikiatri tidak diikutsertakan dalam penelitian. Derajat keparahan AV dinilai dengan skala Lehmann, sedangkan depresi dan stres diukur dengan kuesioner Depression Anxiety and Stress Scale-21 (DASS-21). Analisis data dilakukan menggunakan uji chi-square/Fisher. Distribusi AV derajat ringan ditemukan sebesar 38,64%, sedang 50%, dan berat 11,36%, sesuai dengan pola distribusi menurut kepustakaan. Depresi dan stres ditemukan masing-masing pada 52,27% dan 50%, lebih tinggi dibandingkan dengan populasi umum Indonesia dan setara dengan beberapa penyakit kulit menahun misalnya psoriasis dan dermatitis atopik. Berdasarkan derajatnya, depresi ditemukan pada 2,27% (sangat berat) sampai 22,73% (ringan) subjek. Stres ditemukan pada 2,27% (sangat berat) sampai 20,45% (berat) subjek. Reklasifikasi kelompok depresi dan stres telah dilakukan dalam upaya memenuhi syarat uji statistik, namun tidak diperoleh hubungan yang bermakna antara derajat keparahan AV terhadap depresi (p=0,83; OR=1,12; IK95% 0,26–4,74) maupun stres (p=0,43; OR=1,78; IK95% 0,36–8,70). Temuan ini serupa dengan penelitian sebelumnya, dan menunjukkan bahwa beban psikologis pasien perempuan dewasa dengan AV lebih dipengaruhi faktor eksternal dan persepsi terhadap kondisi AV yang dimiliki, dibandingkan derajat keparahan penyakit itu sendiri. Kemungkinan terdapatnya social desirability bias pada pengisian kuesioner DASS-21 dapat menyebabkan kecenderungan pelaporan yang tidak sesuai dengan kondisi sebenarnya sehingga sebagian subjek masuk dalam kategori tidak depresi atau stres. Hasil penelitian ini menegaskan perlunya penapisan psikologis rutin dan kolaborasi dengan kedokteran jiwa pada penatalaksanaan pada pasien perempuan dewasa dengan AV, bahkan pada derajat ringan sekalipun.
Kata kunci: akne vulgaris, depresi, perempuan dewasa, stres


Acne vulgaris (AV) is a chronic inflammatory disorder of the pilosebaceous follicle, commonly beginning in adolescence, oftentimes persisting into adulthood. Its excerbation is influenced by hormones, stress, and lifestyle, and AV has major impact on quality of life, particularly in females, as it predominantly affects visible facial areas. However, the prevalence and severity of depression and stress in that group, as well as their correlation with disease severity, is not well established. A total of 44 female subjects aged ≥25 years were recruited in a cross-sectional, singe-center study. Subjects with known stressful life events and prior episode of psychiatric disorder were excludes. Acne severity was assessed by Lehmann grading scale, while depression and stress were measured with the Depression Anxiety and Stress Scale-21 (DASS-21). Data was analyzed with Chisquare/Fisher’s exact tests. The study found 38.64% subjects suffered from mild AV, 50% moderate, and 11.36% severe, consistent with figures reported in the literature. Depression and stress were found in 52.27% and 50% of subjects, respectively, higher than the average Indonesian population but comparable to several chronic dermatoses including psoriasis and atopic dermatitis. Based on severity, depression was found ranging between 2.27% (extremely severe) to 22.73% (mild), while stress was observed between 2.27% (extremely severe) to 20.45% (severe). No significant association was found between depression, stress, and AV severity. Reclassification of depression and stress groups were done to perform valid statistical analysis; however, no significant association were obtained in both instances, be it depression (p=0,83; OR=1,12; 95% IC 0,26–4,74), nor stress (p=0,43; OR=1,78; 95% IC 0,36–8,70). These findings indicate that psychological burden in adult females with AV is strongly influenced by external factors and self-perception, rather than solely by acne severity. The possibility of social desirability bias in completing the DASS-21, however, might led to underreporting, resulting in some subjects being categorized as free from depression or stress. This study emphasizes the importance of routine psychological screening and collaboration with psychiatry in the management of adult female patients with AV, even in mild cases.
Keywords: acne vulgaris, depression, adult female, stress