John A G Gibson1, Edward Ackling2, Jonathan I Bisson3, Thomas D Dobbs4, Iain S Whitaker4. 1. Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science 2, Swansea University Medical School, Swansea, UK, SA2 8PP; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK, SA6 6NL. Electronic address: j.a.g.gibson@swansea.ac.uk. 2. School of Medicine, Cardiff University, Cardiff, UK, CF14 4XN. 3. Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK, CF14 4NX. 4. Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science 2, Swansea University Medical School, Swansea, UK, SA2 8PP; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK, SA6 6NL; School of Medicine, Cardiff University, Cardiff, UK, CF14 4XN.
Abstract
BACKGROUND: Facial scarring can have a dramatic effect on a patient's psychological health and wellbeing and present unique management challenges. This patient population remains poorly characterised in the contemporary literature. AIMS: To evaluate the prevalence of, and risk factors associated with affective disorders in adult patients with facial scars. METHODS: A systematic review was conducted using a protocol registered with PROSPERO and in line with the PRISMA statement. A comprehensive search of the literature was conducted using PubMed, MEDLINE, EMBASE, PSYCHInfo and The Cochrane Library. RESULTS: Twenty one studies were included, with a total of 2,394 participants. Using a random effects model, the weighted pooled prevalence of anxiety was 26.1% (95% CI 17.9%-36.3%) and the weighted pooled prevalence of depression was 21.4% (95% CI 15.4%-29.0%). Studies identified female gender, past psychiatric history and violent causation as factors associated with anxiety and depression. LIMITATIONS: Included studies were limited to those published in peer reviewed journals. Longitudinal trends in both anxiety and depression were limited by a short duration of follow up. CONCLUSIONS: There is a high and persistent burden of affective disorders in patients with facial scars. Additional research is required to further characterise this population and develop effective management strategies.
BACKGROUND: Facial scarring can have a dramatic effect on a patient's psychological health and wellbeing and present unique management challenges. This patient population remains poorly characterised in the contemporary literature. AIMS: To evaluate the prevalence of, and risk factors associated with affective disorders in adult patients with facial scars. METHODS: A systematic review was conducted using a protocol registered with PROSPERO and in line with the PRISMA statement. A comprehensive search of the literature was conducted using PubMed, MEDLINE, EMBASE, PSYCHInfo and The Cochrane Library. RESULTS: Twenty one studies were included, with a total of 2,394 participants. Using a random effects model, the weighted pooled prevalence of anxiety was 26.1% (95% CI 17.9%-36.3%) and the weighted pooled prevalence of depression was 21.4% (95% CI 15.4%-29.0%). Studies identified female gender, past psychiatric history and violent causation as factors associated with anxiety and depression. LIMITATIONS: Included studies were limited to those published in peer reviewed journals. Longitudinal trends in both anxiety and depression were limited by a short duration of follow up. CONCLUSIONS: There is a high and persistent burden of affective disorders in patients with facial scars. Additional research is required to further characterise this population and develop effective management strategies.
Authors: James B Badenoch; Isabella Conti; Emma R Rengasamy; Cameron J Watson; Matthew Butler; Zain Hussain; Ben Carter; Alasdair G Rooney; Michael S Zandi; Glyn Lewis; Anthony S David; Catherine F Houlihan; Ava Easton; Benedict D Michael; Krutika Kuppalli; Timothy R Nicholson; Thomas A Pollak; Jonathan P Rogers Journal: EClinicalMedicine Date: 2022-09-08