The association of affective disorders and facial scarring: Systematic review and meta-analysis.

BACKGROUND

Facial scarring can have a dramatic effect on a patient's psychological health and wellbeing and present unique management challenges. This patient population remains poorly characterised in the contemporary literature.

AIMS: To evaluate the prevalence of, and risk factors associated with affective disorders in adult patients with facial scars.

METHODS

A systematic review was conducted using a protocol registered with PROSPERO and in line with the PRISMA statement. A comprehensive search of the literature was conducted using PubMed, MEDLINE, EMBASE, PSYCHInfo and The Cochrane Library.

RESULTS

Twenty one studies were included, with a total of 2,394 participants. Using a random effects model, the weighted pooled prevalence of anxiety was 26.1% (95% CI 17.9%-36.3%) and the weighted pooled prevalence of depression was 21.4% (95% CI 15.4%-29.0%). Studies identified female gender, past psychiatric history and violent causation as factors associated with anxiety and depression.

LIMITATIONS: Included studies were limited to those published in peer reviewed journals. Longitudinal trends in both anxiety and depression were limited by a short duration of follow up.

CONCLUSIONS

There is a high and persistent burden of affective disorders in patients with facial scars. Additional research is required to further characterise this population and develop effective management strategies.