Excessive Tanning: Marker for Depression, Suicidal Behavior?

Megan Brooks

May 04, 2014

NEW YORK ― High school students who frequent the tanning salon may actually be depressed and at risk for suicidal thoughts and behavior, a new study suggests.

Investigators at the University of Arkansas for Medical Sciences (UAMS) in Little Rock found that excessive indoor tanning, defined as tanning 40 times or more in 12 months, was associated with a greater than 2-fold increased odds of depressive symptoms and suicidal thoughts and a greater than 4-fold likelihood of suicide attempt.

On the basis of these findings, high school students who tan excessively "may benefit from depression screening," coauthor and child and adolescent psychiatrist Molly Gathright, MD, told Medscape Medical News.

The study was presented here at the American Psychiatric Association's 2014 Annual Meeting.

Pressure to Be "Perfect"

But Michael E. Thase, MD, professor of psychiatry and director of the mood and anxiety program at the Perelman School of Medicine, University of Pennsylvania, in Philadelphia, cautioned that "screening alone will not help reduce this association. Screening would need to be connected to treatment and monitoring outcome."

"There is so much in the media nowadays about appearance and fitting in and having the perfect body and perfect look," and tanning seems may be one avenue for some teens, Dr. Gathright said.

According to the 2011 Youth Risk Behavior Survey (YRBS), 12% of high school students have reported use of indoor tanning. Excessive indoor tanning was reported in 2.7% of those surveyed.

Previous studies have linked indoor tanning to seasonal affective disorder, anxiety, and substance use. For example, a study reported by Medscape Medical News last month showed that underlying psychiatric distress, including anxiety disorders and substance abuse, may explain why some individuals continue to tan even after experiencing serious negative consequences, such as skin cancer.

The study of more than 500 college students who tan showed that 31% met the criteria for tanning dependence and that 12% met the criteria for problematic tanning.

"We wanted to know if there was a correlation between frequency of indoor tanning with depression and suicidal behavior among the high school population," Dr. Gathright explained.

"There are several studies in the literature on this issue in college students but no studies amongst teens, which is interesting, given that suicide is a leading cause of death among teens," she noted.

Dr. Gathright and UAMS medical student Kelly Taylor used data available from the 2011 YRBS to study the relationship between excessive indoor tanning with depression, defined as 2 weeks of sadness, and suicide ideation, plan, attempt, and treatment. Given biennially since 1991, the YRBS monitors key health-risk behaviors among youth.

After controlling for age, race, and sex, they found a strong positive correlation between reports of excessive indoor tanning and depressive symptoms, suicide ideation, suicide plan, suicide attempt, and treatment for suicide attempt.

Table. Depression and Suicidality With Excessive Indoor Tanning

Outcome Adjusted OR (95% CI)
Depressive symptoms 2.25 (1.6 - 3.2)
Suicide ideation 2.7 (1.9 - 3.9)
Suicide plan 2.7 (1.8 - 4.2)
Suicide attempt 4.6 (3.1 - 6.6)
Treatment for suicide attempt 13.1 (6.8 - 24.9)

OR, odds ratio; CI, confidence interval

 

Dr. Gathright said frequent tanning "could be a marker for depression," adding that young people may use tanning for "mood enhancement effects."

Dr. Thase, who was not involved in the research, said that he is "not surprised" by the findings in this study. "I suspect that people who like to be tanned year round may have some greater risk of having a seasonal pattern to their mood, and hence the wish to look and feel like it's summer," he said.

The authors and Dr. Thase report no relevant financial relationships.

American Psychiatric Association 2014 Annual Meeting. Abstract NR2-185. Presented May 3, 2014.

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