COVID-19 Pandemic Associated With Increased Self-reported Depressive Symptoms in Patients With Congenital Craniofacial Diagnoses

Abstract

Objective The current study investigated the influence of the coronavirus (COVID-19) pandemic on patients with congenital craniofacial diagnoses. Methods Patients (n = 66) with craniofacial diagnoses aged between 8 and 17 were prospectively evaluated with longitudinal psychosocial assessments using the anger, anxiety, depressive symptoms, and peer relationships instruments within the pediatric Patient-Reported Outcomes Measurement Information System (PROMIS). The COVID-19 cohort (n = 33) included patients with assessments within 2 years prior to the pandemic (t0) and during the pandemic (t1; March 2020 to March 2021). An age-matched comparison cohort (n = 33) with similar demographics and diagnoses included patients assessed twice over 3 years prior to the pandemic. Results All PROMIS measures were in the average range clinically for both groups across time points. However, the COVID-19 group reported a significant increase in depressive symptoms during the pandemic (t1) compared to pre-pandemic (t0) scores (48.2 ± 10.1 vs 44.3 ± 9.4, P = .04, d = −0.37), while the comparison group did not demonstrate any differences in psychosocial functioning between t0 and t1. For the COVID-19 cohort, only the pandemic timeframe ( r = 0.21, P = .03) was significantly associated with increased depressive symptom scores, and no other sociodemographic or medical variables were associated with depressive symptoms. Conclusions Self-reported depressive symptoms increased during the COVID-19 pandemic in patients with congenital craniofacial diagnoses. Longitudinal studies are needed to elucidate whether such changes will be persistent or compound known variables associated with psychosocial functioning.

Individuals with Cleft Lip and/or Palate Demonstrated Improved Self-Reported Psychosocial Functioning Following the Onset of the COVID-19 Pandemic

“…Investigations of the psychosocial consequences of CL/P have reported increased risk for depression, anxiety, social and learning difficulties, poor quality of life, and low self-esteem 2 , 3 , 4 , 5 , 6 ; however, other studies found no significant differences in these rates. 3 , 5 , 6 The facial appearance and symmetry of patients with CL/P are commonly rated more negatively than those of nonaffected individuals. In addition, CL/P patients are perceived to display negative-quality facial expressions.…”

“…Bullying typically occurs at school and is mostly related to appearance and/or speech. 2 , 3 , 4 , 5 , 6 …”

“…Analogous effects have been demonstrated since the onset of the coronavirus disease 2019 (COVID-19) pandemic. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 While increased social isolation, limited access to medical care, and stress displayed by family and friends may have been traumatic for the general population, these changes may have had unexpected benefits for CL/P patients. Social distancing may have decreased negative peer interactions, and disruptions in medical care may have provided a break from its attendant psychological burdens.…”

The impact of COVID‐19 on the well‐being of Victorian children born with cleft lip and/or palate

“…21 A study of children with congenital craniofacial diagnoses, including CL/P, revealed that while self-reported depressive symptoms increased during the COVID-19 pandemic, these changes did not relate to an increase in clinical levels of depression. 22 Adults with facial differences, including those with CL/P, reported feelings of relief as a result of reduced social interactions during the COVID-19 pandemic, while also expressing concern regarding a return to normal life. 23 This study was nested within a broader project designed to investigate the mental health impact of the COVID-19 pandemic on children and adolescents with a range of medical conditions.…”

“…They may include uncertainty regarding the timing of surgical procedures due to restricted access to operating theatres, the introduction of telehealth appointments 20 and increased parental stress and anxiety 21 . A study of children with congenital craniofacial diagnoses, including CL/P, revealed that while self‐reported depressive symptoms increased during the COVID‐19 pandemic, these changes did not relate to an increase in clinical levels of depression 22 . Adults with facial differences, including those with CL/P, reported feelings of relief as a result of reduced social interactions during the COVID‐19 pandemic, while also expressing concern regarding a return to normal life 23 …”