Psychosocial Functioning in Patients with Cleft Lip and Palate: A Narrative Review of the Literature

Abstract

Introduction:

Patients with cleft lip and/or palate (CL/P) face unique challenges that extend beyond physical health, affecting their psychosocial well-being. This paper reviews the existing literature on psychosocial outcomes of individuals with CL/P and the various methods employed to evaluate these outcomes.

Methods:

A comprehensive review of current studies was conducted, categorizing findings into 5 primary psychosocial domains: Self-Image, Social Relationships, Psychological Well-Being, Behavioral Adjustment, and Societal Stigma. The review also analyzed methodological variability, including self-report instruments, parent-proxy assessments, and whether measures were cleft-specific.

Discussion:

The findings revealed that children with CL/P, compared to their unaffected peers, may experience lower self-esteem, greater difficulties in social interactions, and increased anxiety or depression. However, studies showed mixed results regarding behavioral adjustment, with some comparable levels of behavioral issues between affected and unaffected children. Adults with CL/P demonstrated resilience in achieving similar levels of education, income, and occupational success as their peers.

Conclusion:

Discrepancies in evaluation of psychosocial wellbeing highlight the need for more standardized methodologies and a holistic approach to assessment. Furthermore, the influence of social stigma remains significant, underscoring the importance of addressing public perceptions of cleft conditions. Care recommendations include: multidisciplinary teams, minimizing unnecessary surgical interventions, self-report outcome instruments, holistic assessment of both deficit-based and asset-based qualities, and increased visibility within mass media.