Stress-coping and cortisol analysis in patients with non-syndromic cleft lip and palate: an explorative study.
BACKGROUND
Non-syndromic clefts of the orofacial region occur in approximately 1 per 500 to 2,500 live births, depending on geographical area and ethnicity. It can be supposed that the disruption of the normal facial structure and the long-standing pressure of treatment from birth to adulthood bring about a range of life stressors which may lead to a long-lasting impact on affected subjects throughout their lives. Therefore, the present study aimed to assess different aspects of psychosocial stress in affected individuals.


METHODS
The study was divided into two parts: first, the Trier Social Stress Test which involves uncontrollability and high levels of social-evaluative stress under real conditions and second, the query of various aspects of coping with psychosocial stress. The test group consisted of 30 affected adult subjects, and an equally sized control group of unaffected volunteers. Cortisol dysregulation was determined by saliva samples before and after stress induction. Meanwhile, participants were asked to complete the SVF 120 stress-coping questionnaire.


RESULTS
The analysis of saliva samples showed a similar baseline concentration as well as a similar increase in cortisol levels after stress induction for both groups. Subsequently, the decline in cortisol concentrations was significantly faster in the CLP group (course: p<0.001; groups: p = 0.102; interaction: p = 0.167). The evaluation of the stress-coping questionnaire revealed a significantly shorter rumination about a stressful event in individuals with CLP-related malformations (p = 0.03).


CONCLUSIONS
We conclude that adults with CLP have significantly better stress-coping strategies than their healthy peers.


BACKGROUND
German Clinical Trials Organization DRKS00003466.
Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany. gassling@mkg.uni-kiel.de
Volker
V
Gassling
Paul-Martin
PM
Holterhus
Dorothee
D
Herbers
Alexandra
A
Kulle
Uwe
U
Niederberger
Jürgen
J
Hedderich
Jörg
J
Wiltfang
Wolf-Dieter
WD
Gerber
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002971:Cleft Lip / Q000378:metabolism* / Q000523:psychology*; D002972:Cleft Palate / Q000378:metabolism* / Q000523:psychology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult
D006854:Hydrocortisone