Psychological Variables in Children and Adolescents with Cleft Lip and/or Palate

Objective: This review analyzes the psychological variables most frequently studied over the last 10 years in children and adolescents with cleft lip/palate (CL/P). Such variables are assumed to be the keys to these patients' psychosocial adjustment. Study design: Articles published from January 2007 to February 2017 were retrieved from PubMed to identify the psychological variables most commonly studied in children and adolescents with CL/P, irrespective of gender or type of cleft. The search terms were “cleft palate” and “psychology”, with the operator AND. Results: Of the 324 articles retrieved, 26 met the criteria for inclusion in the review. The psychological variables most extensively studied over the years were children's social functioning, quality of life and ability to cope. Conclusion: While CL/P patients' quality of life was unanimously agreed to be affected, no consensus was found in the literature on social functioning or coping. In addition to the cleft, patient adjustment was reported to be governed by individual variables and mediators. The range of ages most frequently studied was 7 to 16.

Cleft lip and/or palate; Psychology; Children; Adolescents

1. Santos Lima L, Silveira Ribeiro G, Nascimento de Aquino S,et al. Prevalence of depressive symptoms in patients with cleft lip and palate. Braz JOtorhinolaryngol, 81: 177-183, 2015.

2. Ward JA, Vig KWL, Firestone Ar, Mercado A, De Fonseca M, Johnston W. Oral Health-Related Quality of Life in children with orofacial clefts. Cleft Palate Craniofac J, 50: 174-181, 2013.

3. Boes AD, Murko V, Wood JL,et al. Social function in boys with cleft lip and palate: Relationship of ventral frontal cortex morphology. Behav Brain Res, 181: 224-231, 2007.

4. Wehby GL, Moreno LM. Oral clefts and wellbeing: a lifelong perspective and an agenda for comparative effectiveness research. J Comp Eff Res, 3: 23-28, 2014.

5. Nilsson S, Merlo J, Lyberg-Ahlander V, Psouni E. Psychotropic drug use in adolescents born with an orofacial cleft: a population study. BMJ Open, 5: 1-8, 2015.

6. Sagheri D, Ravens-Sieberer V, Braumann B, Von Marchensen S. An evaluation on Health-Related Quality of Life in a group of 4-7 year-old children with cleft lip and palate. J Orofac Orthop,70: 274-284, 2009.

7. Hutchinson K, Wellman MA, Noe DA, Kahn A. The Psychosocial Effects of Cleft Lip and Palate in Non-Anglo Populations: A Cross-Cultural Meta-Analysis. Cleft Palate Craniofac J, 48: 497-508, 2011.

8. Fadeyibi IO, Coker OA, Zacchariah MP, Fasawe A, Ademiluyi SA. Psychosocial effects of cleft lip and palate on Nigerians: The Ikeja-Lagos experience. J Plast Surg Hand Surg, 46: 13-18, 2012.

9. Collet BR, Speltz ML. A developmental approach to mental health for children and adolescents with orofacial clefts. Orthod Craniofacial Res, 10: 138-148, 2007.

10. Klassen AF, Tsangaris E, Forrest CR et al. Quality of life of children treated for cleft lip and/or palate: A systematic review. J Plast Reconstr Aesthet Surg, 45: 547-557, 2012.

11. Richman LC, McCoy TE, Conrad AL, Nopoulos PC. Neuropsychological, Behavioral, and Academic Sequelae of Cleft: Early Developmental, School Age, and Adolescent/Young Adult Outcomes. Cleft Palate Craniofac J, 49: 387-396, 2012.

12. Stock MN, Hammond V, Owen T, Kiff J, Shanly A, Rumsey N. “Achieving consensus in the measurement of psychological adjustment to cleft lip and/ or palate.” Cleft Palate CraniofacJ, 53: 421-426, 2016.

13. Holder MC, Davis BH, Ward WL. Comorbid psychosocial issues seen in pediatric otolaryngology clinics. Otolaryngol Clin N Am, 47: 779-794, 2014.

14. Lorot-Marchand A, Guerreschi P, Pellein P, Martinot V, Gbaguibi CC, Neiva C, Devauchelle B, Frochisse C, Poli-Merol ML, Francois-Fiquet C. Frequency and socio-psychological impact of taunting in school-age patients with cleft lip-palate surgical repair. Int J Pediatr Otorhinolaryngol, 79: 1041-1048, 2015.

15. Tyler MC, Wehby GL, Robbins JM, Damiano PC. Separation anxiety in children ages 4 through 9 with oral clefts. Cleft Palate Craniofac J, 50: 520-527, 2013.

16. Snyder H, Pope AW. Psychosocial adjustment in children and adolescents with a craniofacial anomaly: Diagnosis-specific patterns. Cleft Palate Craniofac Jl, 47: 264-272, 2010.

17. De Oliveira RL, Santana Santos T, Almeida Teixeira JL, Saguete Martins- Filho PR, Ferreira da Silva LC. Health-Related Quality of Life in patients with a cleft lip and/or palate. J Craniofa Surgy, 26: 2315-2319, 2015.

18. Feragen KB, Borge AIH, Rumsey N. Social experience in 10-year old children born with a cleft. Exploring psychosocial resilience. Cleft Palate Craniofac J, 46: 65-74, 2009.

19. Murray L, Arteche A, Bingley C,et al. The effect of cleft lip on socio-emotional functioning in school-aged children. J Child Psychol Psychiatry, 50: 94-103, 2010.

20. Kramer FJ, Gruber R, Fialka F, Sinikovic B, Hahn W, Schliephake H. Quality of Life in school-age children with orofacial clefts and their families. J Craniofac Surg, 20: 2061-2066, 2009.

21. Kramer FJ, Gruber R, Fialka F, Sinikovic B, Schliephake H. Quality of Life and family functioning in children with nonsyndromic orofacial clefts ar preschool ages. J Craniofac Surg, 19: 580-587, 2008.

22. Collet BR, Cloonan YK, Speltz ML, Anderka M, Werler MM. Psychosocial functioning in children with and without orofacial clefts and their parents. Cleft Palate Craniofac J, 49: 397-405, 2012.

23. Feragen KB, Borge AIH. Peer harassment and satisfaction with appearance in children with and without a facial difference. Body Image, 7: 97-105, 2010.

24. Berger ZE, Dalton LJ. Coping with a cleft II: Factors associated with psychosocial adjustment of adolescents with cleft lip and palate and their parents. Cleft Palate Craniofac J, 48: 82-90, 2011.

25. Feragen KB, Stock NM, Sharratt ND, Kvalem IL. Self-perceptions of romantic appeal in adolescents with a cleft lip and/or palate. Body Image, 18: 143-152, 2016.

26. Berger ZE, Dalton LJ. Coping with a cleft: Psychosocial adjustment of adolescents with a cleft lip and palate and their parents. Cleft Palate Craniofac J, 46: 435-443, 2009.

27. Feragen KB, Kvalem IL, Rumsey N, Borge AIH. Adolescents with and without a facial difference: The role of friendships and social acceptance in perceptions of appearance and emotional resilience. Body Image, 7: 271-279, 2010.

28. Broder HL, Wilson-Genderson M, Sischo L. Examination of a theoretical model for Oral Health-Related Quality of Life among youths with cleft. Am J Public Health, 104: 865-871, 2014.

29. Eslami N, Reza Majidi M, Aliakbarian M, Hasanzadeh N. Oral Health-Related Quality of Life in children with cleft lip and palate. J Craniofac Surg, 24: e340-e343, 2013.

30. Piombino P, Ruggiero F, Dell´Aversana Orabona Get al. Development and validation of the Quality of Life Adolescent Cleft Questionnaire in patients with cleft lip and palate. J Craniofac Surg, 25: 1757-1761, 2014.

31. Damiano PC, Tyler MC, Romitti PA,et al. Health-Related Quality of Life among preadolescents children with oral clefts: The mother´s perspective. Pediatrics, 120: e283-e290, 2007.

32. Wehby GL, Tyler MC, Lindgren S, Romitti P, Robbins J, Damiano P. Oral clefts and behavioural health of young children. Oral Dis, 18: 74-84, 2012.

33. Bos A, Prahl C. Oral Health-Related Quality of Life in Dutch children with cleft lip and/or palate. Angle Orthod, 81: 865-871, 2011.