Concealment, depression and poor quality of life in patients with congenital facial anomalies.
OBJECTIVE
Studies have shown that patients with congenital facial anomalies are vulnerable to depression. In addition, concealment of facial anomalies in an effort to mask handicaps is common, and these patients also often have difficulties with interpersonal relationships and in social situations. Despite this, no previous study has investigated the association between concealment of facial anomalies and depression, and a patient's quality of life.


METHODS
A group of 65 patients, who had been scheduled for plastic surgery, completed this study. A total of 50 patients who had congenital facial anomalies, some of whom concealed their facial anomalies (N=22), and some whom didn't (N=28), as well as 15 patient controls were interviewed and subsequently administered the Beck Depression Inventory-II (BDI-II), the Structured Clinical Interview for DSM-IV (SCID), the Millon Behavioral Medicine Diagnostic (MBMD) and the WHO Quality of Life (WHOQOL).


RESULTS
Among patients with congenital facial anomalies, those who concealed their anomalies exhibited a significantly higher level of depression and anxiety; higher rates of self-accusation, dissatisfaction, hypochondria, weight loss and antisocial personality traits; and a lower quality of life than those who did not conceal their anomalies. To the contrary, no significant differences were found with respect to depression, anxiety and quality of life between the congenital facial anomaly group and controls. Further, the concealment of facial anomalies was a significant predictor for lifetime major depressive disorder (odds ratio (OR)=7.1, 95% confidence interval (CI) 1.4-37.3), after adjusting for age, gender and microtia.


CONCLUSIONS
Facial concealment is a significant predictor of depression and poor quality of life in patients with congenital facial anomalies.
Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
So-Young
SY
Lim
Dongsoo
D
Lee
Kap Sung
KS
Oh
Bora
B
Nam
Sa-Ik
SI
Bang
Goo-Hyun
GH
Mun
Jai-Kyong
JK
Pyon
Ji-Hae
JH
Kim
Se
S
Chang Yoon
Hyo-Seok
HS
Song
Hong Jin
HJ
Jeon
D000293:Adolescent; D000328:Adult; D000987:Antisocial Personality Disorder / Q000453:epidemiology; D001007:Anxiety / Q000453:epidemiology*; D000013:Congenital Abnormalities / Q000523:psychology; D003863:Depression / Q000453:epidemiology*; D005145:Face / Q000002:abnormalities*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010551:Personality; D011594:Psychometrics; D011788:Quality of Life; D055815:Young Adult