Prevalence of Depression and Anxiety Among Acne Patients Attending Primary Care Clinics in Mosul

Background: Acne vulgaris is a common chronic dermatological condition that predominantly affects adolescents and young adults and is increasingly recognized to have significant psychological consequences. The visibility of acne lesions, particularly on the face, may lead to emotional distress, low self-esteem, and social impairment. Depression and anxiety are among the most frequently reported psychiatric comorbidities in patients with acne; however, these conditions often remain underdiagnosed in primary care settings. Objectives: To determine the prevalence of depression and anxiety among patients with acne attending primary care clinics in Mosul city, and to assess the association between acne severity and the presence of psychological distress. Methods: A cross-sectional study was conducted among 200 patients with acne vulgaris attending Al Sukar Primary Health Care Center. Data were collected through direct interviews using a structured questionnaire that included sociodemographic variables and clinical assessment of acne severity (mild, moderate, severe). Psychological assessment was performed using the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. Data were analyzed using SPSS, and associations were tested using the Chi-square test with a significance level of p ≤ 0.05. Results: Among the 200 participants, 40.5% had mild acne, 39.5% moderate acne, and 20.0% severe acne. Regarding depression, 40.5% had minimal symptoms, while 59.5% exhibited varying degrees of depression, including 29.5% mild, 16.5% moderate, 8.5% moderately severe, and 5.0% severe depression. Anxiety was also prevalent, with 44.5% having minimal anxiety and 55.5% experiencing anxiety symptoms (30.5% mild, 14.5% moderate, and 10.5% severe). A statistically significant association was found between acne severity and both depression and anxiety (p ≤ 0.05), with higher levels of psychological distress observed among patients with more severe acne. Conclusions: Acne vulgaris is associated with a considerable burden of depression and anxiety among patients in primary care settings. The findings emphasize the need for integrating psychological assessment into routine acne management and adopting a holistic approach to improve patient outcomes.