Quality of Life and Psychosocial Well-being in Adolescents with Cleft Lip and Palate Scars: A Cross-Sectional Study with Gender-Based Analysis

Abstract

Aim: This study aimed to investigate psychosocial well-being, focusing on anxiety, depression, and self-concept, among adolescents with and without cleft lip and palate (CLP) scars, considering gender-related differences as potential determinants of quality of life (QoL). Study Design:  Cross-sectional observational study. Methodology: A cross-sectional study was conducted with 237 adolescents aged 12–18 years, including 79 participants with CLP scars and 158 without CLP scars. Participants completed a sociodemographic questionnaire and validated psychosocial instruments: the Generalized Anxiety Disorder scale (GAD-7), the Patient Health Questionnaire (PHQ-9), and the Rosenberg Self-Esteem Scale. Group comparisons were performed using Student’s t-tests and analysis of variance (ANOVA), with a significance level set at 5%. Results: Adolescents with CLP scars showed slightly higher frequencies of moderate to severe anxiety (15.0% vs. 11.7%), depression (13.9% vs. 10.5%), and low self-concept (17.5% vs. 11.7%) compared with their peers without CLP scars; however, these differences were not statistically significant (P > 0.05). In contrast, female adolescents, regardless of CLP status, exhibited significantly higher levels of anxiety (P = 0.001) and depression (P = 0.002), as well as lower self-concept (P = 0.001), particularly among those aged 14–17 years. Conclusion: The presence of CLP scars alone did not significantly impact psychosocial well-being in adolescence. However, female gender emerged as a key determinant associated with increased vulnerability to anxiety, depression, and reduced self-concept. These findings highlight the importance of incorporating gender-sensitive perspectives into psychosocial assessment and quality-of-life–oriented support strategies for adolescents, particularly those living with visible craniofacial conditions.