Anxiety and depression in adolescents with a visible difference: A systematic review and meta-analysis

van Dalen, Marije; Dierckx, Bram; Parsmans, Suzanne; Aendekerk, E. W. C.; Mathijssen, Irene; Koudstaal, Maarten Jan; Timman, Reinier; Williamson, Heidi; Hillegers, Manon; Utens, Elisabeth; Okkerse, Jolanda

Abstract

Living with a visible difference can entail challenging social situations, associated with psychosocial symptoms. However, it is not clear whether adolescents with a visible difference experience more anxiety and depression than unaffected peers. We aim to determine whether adolescents with a visible difference experience more symptoms of anxiety and depression than unaffected peers. A literature search was conducted in Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, PsycINFO Ovid, and Google Scholar. Meta-analyses were done using random-effects models to calculate a standardised mean difference. Analyses for subgroups were used to study causes of visible difference. Eleven studies were identified (n = 1075, weighted mean age = 15.80). Compared to unaffected peers, adolescents with a visible difference experience more symptoms of anxiety (SMD = 0.253, 95 % CI [0.024, 0.482], p = .030), but not depression (SMD = 0.236, 95 % CI [−0.126, 0.599], p = .202). Adolescents with a skin condition did not experience more symptoms of anxiety (SMD = 0.149, 95 % CI [−0.070, 0.369], p = .182) or depression (SMD = 0.090, 95 % CI [−0.082, 0.262], p = .305) when compared to unaffected peers. Overall, more symptoms of anxiety are found in adolescents with a visible difference compared to peers. No differences in anxiety or depression were found for skin differences. Screening for anxiety is recommended.

• Journal Article Type: Article
• Acceptance Date: Feb 11, 2020
• Online Publication Date: Feb 21, 2020
• Publication Date: Jun 1, 2020
• Deposit Date: Apr 28, 2020
• Publicly Available Date: Apr 28, 2020
• Journal: Body Image
• Print ISSN: 1740-1445
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 33
• Pages: 38-46
• DOI: https://doi.org/10.1016/j.bodyim.2020.02.006
• Keywords: Anxiety/Anxiety disorders; Depression; Visible differences; SAD/social anxiety
• Public URL: https://uwe-repository.worktribe.com/output/5352230
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1740144519304048?via%3Dihub