title: Orthognathic surgery improves quality of life and depression, but not anxiety, and patients with higher preoperative depression scores improve less.
abstract: This study assessed quality of life (QoL), depression, and anxiety before and after orthognathic surgery and identified risk factors for poorer postoperative outcome. This multicentre prospective study included 140 patients from five French medical centres. We assessed patients before surgery (T1), 3 months after surgery (T2), and 12 months after surgery (T3). We assessed the severity of the orofacial deformity, physical, psychological, social, and environmental QoL (WHOQOL-BREF), and depression and anxiety (GHQ-28). Risk factors for poorer outcome were identified using linear mixed models. Between baseline and 12 months, there was significant improvement in psychological and social QoL and in depression (although below the norms reported in the general population), but not in anxiety. Physical QoL was poorer in patients who were younger, who had a mild orofacial deformity, and who were depressed. Psychological QoL was poorer in younger patients and in depressed patients. Social QoL was poorer in patients who were single, who had a mild orofacial deformity, and who were depressed. Although orthognathic surgery provides a moderate improvement in psychological and social QoL, the systematic screening and treatment of depression could further improve QoL after surgery because it is a major predictor of poor QoL in this population.
authors.affiliation: CHRU de Tours, Équipe de Liaison et de Soins en Addictologie, Tours, France; CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France; Université François Rabelais de Tours, PRES Centre-Val de Loire Université, Département de Psychologie, Tours, France. Electronic address: paul.brunault@univ-tours.fr.
authors.forename: P
authors.initials: P
authors.lastname: Brunault
authors.affiliation: Université François Rabelais de Tours, PRES Centre-Val de Loire Université, Département de Psychologie, Tours, France.
authors.forename: J
authors.initials: J
authors.lastname: Battini
authors.affiliation: Université d'Angers, Laboratoire de Psychologie des Pays de la Loire, EA 4638, Maison de la Recherche Germaine Tillion, Angers, France.
authors.forename: C
authors.initials: C
authors.lastname: Potard
authors.affiliation: CHRU de Tours, Service de Psychiatrie A, Tours, France.
authors.forename: C
authors.initials: C
authors.lastname: Jonas
authors.affiliation: Clinique Saint-André, Vandœuvre-lès-Nancy, France.
authors.forename: B
authors.initials: B
authors.lastname: Zagala-Bouquillon
authors.affiliation: Clinique Saint-André, Vandœuvre-lès-Nancy, France.
authors.forename: A
authors.initials: A
authors.lastname: Chabut
authors.affiliation: CHRU de Nantes, Service de Chirurgie Maxillo-Faciale, Nantes, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Mercier
authors.affiliation: CHP de Rennes, Clinique Saint-Grégoire, Rennes, France.
authors.forename: N
authors.initials: N
authors.lastname: Bedhet
authors.affiliation: Université François Rabelais de Tours, PRES Centre-Val de Loire Université, Département de Psychologie, Tours, France.
authors.forename: C
authors.initials: C
authors.lastname: Réveillère
authors.affiliation: CHRU de Tours, Service de Chirurgie Maxillo-Faciale, Tours, France.
authors.forename: D
authors.initials: D
authors.lastname: Goga
authors.affiliation: CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France; Université François Rabelais de Tours, PRES Centre-Val de Loire Université, Département de Psychologie, Tours, France.
authors.forename: R
authors.initials: R
authors.lastname: Courtois
mesh_terms: D000328:Adult; D000367:Age Factors; D001008:Anxiety Disorders / Q000517:prevention & control / Q000523:psychology*; D003866:Depressive Disorder / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D017533:Marital Status; D019767:Maxillofacial Abnormalities / Q000523:psychology* / Q000601:surgery*; D056948:Orthognathic Surgical Procedures; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: anxiety; depression; orofacial deformities; orthognathic surgery; physical quality of life; predictors; psychological quality of life; quality of life; risk factors; social quality of life