Anxiety, Depression, and Quality of Life in Caregivers of Children with Cleft Lip and Palate: A Systematic Review

Abstract

Context: Cleft Lip and Palate (CL/P) is the most common craniofacial malformation in the oral cavity, with a prevalence of “1 to 2in 1,000 live births worldwide. Parents with CL/P children are more prone to experience emotional disorders, especially depression, and have higher child-related stress than the parents of normal children. Due to the effect of the mental status of parents on children, the assessment of the psychological aspects of this problem and its effects on the patients and their parents is critical. Evidence Acquisition: This systematic review was carried out to determine the quality of life (QoL) and emotional problems, including anxiety and depression, in the mothers of CL/P children. All the published studies were searched in three electronic databases, including MEDLINE, PubMed, and Web of Science, up to December 30, 2020, using the keywords "Orofacial Clefts” and “Cleft Lip and Palate” in combination with “Anxiety," "Stress," "Depression," and "Quality of Life” in addition to “Parents," "Mothers," "Fathers," and "Caregivers." Results: Finally, 29 articles met the eligibility criteria for this review. Due to the differences in health care and culture, controversial findings were obtained on the QoL of parents with CL/P children. Social support plays a vital role in the prevention, resolution, and treatment of psychological problems of parents with CL/P children. The majority of studies confirmed the higher levels of anxiety and depression in caregivers of children with CL/P than in normal individuals. Conclusions: These findings emphasize the necessity of psychological screening in the first few months following the diagnosis to facilitate providing appropriate psychological support for parents with CL/P children.

Evaluation of Anxiety in Turkish Parents of Newborns with Cleft Palate with or Without Cleft Lip

“…The challenges continue with frequent hospital visits, coping with the anxiety of the first anesthesia, witnessing their child's discomfort after surgery, and caring for their infant, especially in the first year of life. 26 In their systematic review, Namdar et al 27 reported that 6 of 19 studies evaluating anxiety in mothers with CL/P children demonstrated higher anxiety levels among mothers with CL/ P children than in the general population. Similar to the present study, another study conducted in the Turkish population reported that mothers of infants born with CL/P had higher mean parenting stress scores than the mothers of healthy infants, regardless of cleft type.…”

“…In their systematic review, Namdar et al 27 reported that 6 of 19 studies evaluating anxiety in mothers with CL/P children demonstrated higher anxiety levels among mothers with CL/P children than in the general population. Similar to the present study, another study conducted in the Turkish population reported that mothers of infants born with CL/P had higher mean parenting stress scores than the mothers of healthy infants, regardless of cleft type.…”

Gaps Between the Indication and the Home Execution of Massage Therapy in Children in the Postsurgical Stage of Primary Cheiloplasty or Rhinocheiloplasty

“…Considering that mothers are in charge of performing the massage, it is essential to investigate their emotional state and mental health since, as reported by Namdar et al 15 they have a greater tendency to show depressive signs than mothers of children without CL/P, 16 which can be enhanced by the feeling of guilt reported by some mothers for not being able to carry out the indicated therapy. It would be appropriate to assess the mental health of the mothers of children with CL/P as a screening method for those who need support in this area, which would improve adherence to physical therapy.…”

Auckland Regional Cleft Palate Service: service accessibility and speech outcomes

“…There are internationally recognised psychosocial impacts on whānau, especially those with lower household incomes. [6][7][8] Psychosocial wellbeing and positive engagement with services has been strongly linked with early diagnosis and counselling, establishing a close relationship with the MDT and social supports. 7…”