A Clinical Report: Mental health, Self-esteem and Social Interaction in Adolescents with CL/P in the Context of Re-constructive Surgery

Abstract

otoplasty surgery. However, the question of (self assessed) self-esteem remains unanswered, as it seems unaffected by reconstructive surgery The Current StudyThe aim of the study was to continue the search for new ways of conceptualizing of self-esteem by asking adolescents to look back on changes in the levels of their self-esteem that can be meaningfully connected to age-related life experiences and context, such as, for instance reconstructive surgery. [17,18,19] In this study we focused on young patients with cleft-lip and palate (CLP) during the final stages of reconstructive surgery. At this stage in the process, the initial steps of medically necessary interventions had been dealt with and now the more aesthetic part of the treatment was on the agenda. Plastic surgeons involved in this field often ask themselves why some adolescents ask for surgery while others do not. Is this a question of mental health or pressure from others?A pilot study was performed with the aim of exploring important Abstract Background: Self-esteem in children and adolescents with deviances in function and appearance has been studied with diverse results. The effect of cleft lip/ and palate on mental health, self-esteem and social interaction were studied in the context of reconstructive surgery. Comparing parents' and children's' self-esteem reports was also of interest. Exploring these differences could help the understanding of future mental health in patients with CL/P and their need for reconstructive surgery. Methods:A descriptive study within an in-patient setting, Plastic Surgery Clinic, Uppsala University Hospital. Twenty-six CL/P patients between 13 and 19 years of age and their parents answered a specific condition questionnaire specially adapted for this study and Beck's Youth Inventories the day before reconstructive surgery.Results: Mental health was affected while self-esteem was on a median-high level for this CL/P group. Parents rated their children to have higher self-esteem as they grew older. However, females reported a diminished level from primary to secondary school age. Attention on CLP was high. Twenty-three adolescents, or 85 % of resondents, wanted to change their appearance, Conclusion: Mental health was affected by CL/P, especially for those children that had been bullied. Specifically, the wish to change appearance was associated with high level of anxiety and depression. The specific condition questionnaires proved to be more informative than the standardized measure regarding self-esteem under development for the sake of differentiating between parent-adolescent estimation of self-esteem.