title: Psychological impact of visible differences in patients with congenital craniofacial anomalies.
abstract: BACKGROUND
  Patients with craniofacial anomalies often have appearance concerns and related social anxiety which can affect their quality of life. This study assessed the psychological impact of facial and dental appearance in patients with craniofacial anomalies in comparison to a general population control group.
  
  
  METHODS
  The study involved 102 adult patients (51% male) with congenital craniofacial anomalies and 102 controls (49% male). Both groups completed the Nepali version of Derriford Appearance Scale (DAS) and the Psychological Impact of Dental Aesthetic Questionnaire (PIDAQ) in a clinical setting to assess appearance-related distress, avoidance, and anxiety.
  
  
  RESULTS
  There was a significant difference between patients and controls on both PIDAQ (mean score for patients 33.25 ± 9.45 while for controls 27.52 ± 5.67, p < 0.001) and DAS59 scores (mean score for patients 159.16 ± 31.54 while for controls 77.64 ± 6.57, p < 0.001), indicating that patients experienced greater negative psychological impact of living with their appearance (PIDAQ) and more appearance-related distress (DAS) than controls. DAS scores were not associated with gender. There was no association of the place of residence (rural vs. urban) with PIDAQ or DAS59 scores.
  
  
  CONCLUSIONS
  There is a significant psychological impact of altered facial and dental appearance in patients with craniofacial anomalies compared to controls. There was no effect of locality (rural/urban) on the psychological impact of facial and dental appearance in patients.
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, Nobel Medical College and Teaching Hospital, Kanchanbari, Biratnagar, 56700, Nepal, varundc@gmail.com.
authors.forename: Varun Pratap
authors.initials: VP
authors.lastname: Singh
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Moss
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D002971:Cleft Lip / Q000523:psychology; D002972:Cleft Palate / Q000523:psychology; D019465:Craniofacial Abnormalities / Q000523:psychology*; D003398:Craniosynostoses / Q000523:psychology; D004954:Esthetics; D005260:Female; D006053:Goldenhar Syndrome / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011788:Quality of Life; D012423:Rural Health; D012649:Self Concept; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology; D014504:Urban Health; D055815:Young Adult