28402064

PMC5568049

Background

Oral clefts (OC) are among the most common congenital malformations and can have a large impact on the life of the affected individual. Research findings regarding the psychological and psychosocial consequences of OC are inconclusive.

Methods

Using Danish nationwide registers we investigated redeemed prescriptions of psychotropic medication 1996–2012 and visits to psychiatrists and psychologists 1996–2011 among individuals born with non-syndromic OC in Denmark 1936–2009 and a comparison cohort of individuals without OC. This includes 8,244 individuals with OC and 82,665 individuals without OC.

Results

Cox-regression analysis revealed 12% (95%CI: 7%–16%) increased risk of using any psychotropic medication for individuals with OC. When examining by cleft type, higher risks for medication use were observed in individuals with cleft lip and palate (CLP) or cleft palate only (CP). The largest increased relative risk was found for use of antipsychotics and stimulants for individuals with CP followed by use of antipsychotics for individuals with CLP. We found increased risk of visits to psychiatrists for individuals with CP and no increased risk for visits to psychologists for either group.

Conclusions

This study indicates that a small group of individuals with non-syndromic OC, in particular those with palatal involvement, have greater risk of using psychotropic medications. Elevated use was however also observed among younger individuals with cleft lip only. There seems to be only a modest increase in visits to health professionals for psychological reasons. Undiagnosed syndromes, e.g. 22q11 deletion syndrome, may however contribute to an overestimation of the associations.

CDC Public Access

R01 DD000295/DD/NCBDD CDC HHS/United States
R01 DE020895/DE/NIDCR NIH HHS/United States

Denmark