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.

Citation

van Dalen, M., Dierckx, B., Parsmans, S., Aendekerk, E. W. C., Mathijssen, I., Koudstaal, M. J., …Okkerse, J. (2020). Anxiety and depression in adolescents with a visible difference: A systematic review and meta-analysis. Body Image, 33, 38-46. https://doi.org/10.1016/j.bodyim.2020.02.006

• 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