Quality of Life and Psychosocial Well-being in Adolescents with Cleft Lip and Palate Scars: A Cross-Sectional Study with Gender-Based Analysis
Jussimar Scheffer Castilhos
Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
Gil Guilherme Gasparello
Pontifícia Universidade Católica do Paraná, Curitiba, Brazil and Research Unit of Oral Health, University of Oulu, Oulu, Finland.
Leticia Machado Berretta
Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
Giovani Ceron Hartmann
Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
Mohamad Jamal Bark
Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
Matheus Melo Pithon
Southwest Bahia State University - UESB. Jequié, Bahia, Brazil.
Orlando Motohiro Tanaka *
Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aim: This study aimed to investigate psychosocial well-being, focusing on anxiety, depression, and self-concept, among adolescents with and without cleft lip and palate (CLP) scars, considering gender-related differences as potential determinants of quality of life (QoL).
Study Design: Cross-sectional observational study.
Methodology: A cross-sectional study was conducted with 237 adolescents aged 12–18 years, including 79 participants with CLP scars and 158 without CLP scars. Participants completed a sociodemographic questionnaire and validated psychosocial instruments: the Generalized Anxiety Disorder scale (GAD-7), the Patient Health Questionnaire (PHQ-9), and the Rosenberg Self-Esteem Scale. Group comparisons were performed using Student’s t-tests and analysis of variance (ANOVA), with a significance level set at 5%.
Results: Adolescents with CLP scars showed slightly higher frequencies of moderate to severe anxiety (15.0% vs. 11.7%), depression (13.9% vs. 10.5%), and low self-concept (17.5% vs. 11.7%) compared with their peers without CLP scars; however, these differences were not statistically significant (P > 0.05). In contrast, female adolescents, regardless of CLP status, exhibited significantly higher levels of anxiety (P = 0.001) and depression (P = 0.002), as well as lower self-concept (P = 0.001), particularly among those aged 14–17 years.
Conclusion: The presence of CLP scars alone did not significantly impact psychosocial well-being in adolescence. However, female gender emerged as a key determinant associated with increased vulnerability to anxiety, depression, and reduced self-concept. These findings highlight the importance of incorporating gender-sensitive perspectives into psychosocial assessment and quality-of-life–oriented support strategies for adolescents, particularly those living with visible craniofacial conditions.
Keywords: Quality of life, psychosocial well-being, adolescent; anxiety, self concept, cleft lip and palate