OBJECTIVE: To integrate results of available studies that compared levels of depressive symptoms of children and adolescents with chronic physical illness to healthy peers or test norms. METHODS: Random-effects meta-analysis was computed with 340 studies and 450 subsamples. RESULTS: Children and adolescents with chronic illness have, on average, higher levels of depressive symptoms than their healthy peers (d = .19 SD units). Differences are strongest for chronic fatigue syndrome (d = .94), fibromyalgia (d = .59), cleft lip and palate (d = .54), migraine/tension head ache (d = .51), and epilepsy (d = .39). Larger effect sizes were found in studies with higher proportion of girls, with a healthy control group, from developing countries, published before 1990, and that used parent rating or clinician ratings rather than child ratings. CONCLUSIONS: Pediatricians and others working with children with chronic illnesses should screen children with chronic physical illness for symptoms of psychological distress and make appropriate referrals for mental health services, when needed. Language: en

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Depressive Symptoms in Children and Adolescents with Chronic Physical Illness: An Updated Meta-Analysis

Objective: Adjustment to cleft lip and/or palate (CL/P) is multifaceted, involving several domains of psychological and social functioning. A substantial increase in research in this area has been evident in recent years, along with a preliminary shift in how adjustment to CL/P is conceptualised and measured. An updated and comprehensive review of the literature is needed in light of the rapidly expanding and changing field.Design: A narrative review of 148 quantitative and qualitative studies published between January 2004 and July 2015.Main outcome measures: Findings are presented according to five key domains of adjustment: Developmental Trajectory, Behaviour, Emotional Well-being, Social Experiences and Satisfaction with Appearance and Treatment. Data pertaining to General Psychological Well-being were also examined.Results: The overall impact of CL/P on psychological adjustment appears to be low. Nonetheless, the review demonstrates the complexity of findings both within and across domains, and highl...

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Psychological adjustment to cleft lip and/or palate: A narrative review of the literature.

Cleft of lip and palate are most common serial congenital anomalies to affect the orofacial region . It can occur isolated or together in various combination and/or along with other congenital deformities particularly congenital heart diseases. .Patient with oro-facial cleft deformity needs to be treated at right time and at right age to achieve functional and esthetic well being. Successful management of the child born with a cleft lip and palate requires coordinated care provided by a number of different specialties including oral/maxillofacial surgery, otolaryngology, genetics/dysmorphology, speech/language pathology, orthodontics, prosthodontics, and other. This article aims to the review the point primary care physicians in literature knowledge about cleft lip and palate. A review of literature have made to discuss introduction, epidemiology, clinical feature, etiology factor and management of cleft lip and palate.

Cleft of lip and palate: A review.

Psychological Aspects of Reconstructive and Cosmetic Plastic Surgery: Clinical, Empirical, and Ethical Perspectives

OBJECTIVE To provide a meta-analysis of research that has examined the cognitive functioning of children and adults with cleft lip (CL), cleft palate (CP), and cleft lip and palate (CLP). METHODS Data from 29 studies, which compared persons with a cleft to a control group on tests of cognitive functioning, were analyzed. The data were obtained from 1,546 persons with cleft and 279,805 controls. RESULTS Participants with a cleft performed significantly worse on 7 cognitive domains. However, the only moderate and significant deficit, which was based on nonheterogeneous study findings and not subject to publication bias, was in the language domain. CL, CP, and CLP were all associated with cognitive impairments, although the profiles for the groups differed. CONCLUSIONS Cross-sectional studies suggest that persons with clefts experience poorer cognitive functioning across a range of domains, although large-scale longitudinal studies are needed to more definitively differentiate outcomes by cleft type.

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Cognitive functioning in children and adults with nonsyndromal cleft lip and/or palate: a meta-analysis.

Vocational and social issues affect rehabilitation and development of patients with cleft lip and cleft palate. However, psychological problems like lowered self esteem and difficulties in social interaction have also been noted in them. Not many pediatric reconstructive surgery teams have a psychiatrist on their panel. It is likely that psychological problems are higher in incidence than literature actually suggests. Hence it is very essential that such cases are identified by the surgical team to maximize positive outcome of surgery and rehabilitation. This study discusses psychological issues revolving around cleft lip and cleft palate along with lacunae in many psychological research studies.

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Shibani Devare

Papers

Psychological issues in cleft lip and cleft palate