Objectives: To determine the psychosocial status of children and young adults with cleft lip and/ or palate (CLP).

Methods: One hundred and sixty children and young adults with CLP aged from 8 to 21 years were included in this study. A group of 108 children and young adults of similar age and gender who did not have CLP acted as controls. A parent of each young person also participated.

Psychosocial status was established using a number of validated measures to assess anxiety, depression, self-esteem and behaviour problems. Visual analogue scales were used to determine the young person’s satisfaction with facial appearance and the parent’s opinion of their child in terms of anxiety, self-esteem, satisfaction with facial appearance, and general happiness. Parents also completed the Child Behaviour Checklist. Data were analysed using multivariate regression analysis.

Results: No significant differences were established between those with CLP and controls regarding anxiety, self-esteem or depression. However, those with a visible scar reported a greater number of depressive symptoms.

Children and young adults with CLP had a higher incidence of self-reported behaviour problems compared to controls (p=.003) including greater social problems (p=.002) and attention problems (p=.04).

Participants with a visible scar had significantly lower ratings of satisfaction with appearance than those without a scar (p=.01). Parents of children with a visible scar were more likely to report that their child had a greater incidence of behaviour problems (p=.001), was more withdrawn (p=.001), and more anxious and depressed (p=.000) than parents of children who did not have a visible scar.

Conclusions: Children with CLP reported a greater incidence of behaviour problems compared to controls. Having a visible scar reduced satisfaction with facial appearance and increased parents’ reports of behaviour problems.

Funding: R&D Office, Northern Ireland Health and Social Services