Self-reports of psychosocial functioning among children and young adults with cleft lip and palate.
OBJECTIVE
A cross-sectional study was employed to determine the psychosocial effects of cleft lip and/or palate among children and young adults, compared with a control group of children and young adults without cleft lip and palate.


METHODS
The study comprised 160 children and young adults with cleft lip and/or palate and 113 children and young adults without cleft lip and/or palate. All participants were between 8 and 21 years of age.


METHODS
Psychological functioning (anxiety, self-esteem, depression, and behavioral problems) was assessed using validated psychological questionnaires. Happiness with facial appearance was rated using a visual analog scale. Social functioning, including experience of teasing/bullying and satisfaction with speech, was assessed using a semistructured interview.


RESULTS
Participants with cleft lip and/or palate reported greater behavioral problems (p < .001) and more symptoms of depression (p < .01); they were teased more often (p < .001) and were less happy with their facial appearance (p < .01) and speech (p < .001), compared with controls. There were no significant difference between subjects with cleft lip and/or palate and subjects without cleft lip and/or palate in terms of anxiety (p > .05) or self-esteem (p > .05). Having been teased was a significant predictor of poor psychological functioning, more so than having a cleft lip and/or palate per se (p < .001).


CONCLUSIONS
Teasing was greater among participants who had cleft lip and/ or palate and it was a significant predictor of poorer psychosocial functioning. Children and young adults with cleft lip and/or palate require psychological assessment, specifically focusing on their experience of teasing, as part of their routine cleft care.
Hunt
Orlagh
O
School of Dentistry, Queen's University Belfast, Belfast, Northern Ireland. o.hunt@qub.ac.uk
Burden
Donald
D
Hepper
Peter
P
Stevenson
Mike
M
Johnston
Chris
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000150:complications; D002648:Child; D002971:Cleft Lip / Q000150:complications / Q000523:psychology*; D002972:Cleft Palate / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000150:complications; D004812:Epidemiologic Methods; D005260:Female; D006240:Happiness; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications; D012649:Self Concept; D012917:Social Adjustment