The Association of Receiving a Diagnosis of Idiopathic Scoliosis with the Self-Esteem and Mental Health of Pediatric Patients: A Cohort Study.
Patients with adolescent idiopathic scoliosis (AIS) are at increased risk of emotional distress, yet little is known about the immediate psychological impact of receiving the diagnosis itself. This study aimed to evaluate short-term changes in self-esteem, anxiety, depression, and stress before and after AIS diagnosis, and in the early post-diagnostic period.
In this cohort study, 179 adolescents (10-18 years) referred for suspected AIS completed the Rosenberg self-esteem scale (RSES) and Depression, Anxiety and Stress Scale (DASS 21) before clinical and radiographic assessment (T1). Based on clinical findings and Cobb angle measurements, participants were classified as having mild scoliosis (Cobb angle > 10°, <20°) managed with observation alone (Group A, n = 30), moderate/severe scoliosis (Cobb angle > 20°), candidates for bracing treatment (Group B, n = 30), or no scoliosis (Group C, n = 119). Adolescents with scoliosis (Groups A and B) repeated the questionnaires immediately after diagnosis and treatment recommendations (T2). Group B completed a third assessment 1-2 months after initial examination (T3).
At baseline, RSES and DASS 21 scores did not differ significantly between groups. Following diagnostic disclosure, Group A showed a significant decline in self-esteem, while both groups showed increases in stress, anxiety, and depression. In Group B, reassessed at T3, stress and anxiety decreased, whereas depression remained elevated relative to baseline.
AIS diagnosis was associated with a self-esteem decline that followed a pattern dependent on curve severity, with an immediate drop in mild AIS (Group A) versus a delayed decline emerging one to two months later in moderate/severe cases (Group B). Anxiety and depressive symptoms increased significantly in both groups, while stress increased significantly only in those with moderate/severe scoliosis (Group B). Routine screening of mental health after AIS diagnosis, alongside interdisciplinary care involving mental health professionals, may help identify vulnerable patients and enable timely psychosocial support.
In this cohort study, 179 adolescents (10-18 years) referred for suspected AIS completed the Rosenberg self-esteem scale (RSES) and Depression, Anxiety and Stress Scale (DASS 21) before clinical and radiographic assessment (T1). Based on clinical findings and Cobb angle measurements, participants were classified as having mild scoliosis (Cobb angle > 10°, <20°) managed with observation alone (Group A, n = 30), moderate/severe scoliosis (Cobb angle > 20°), candidates for bracing treatment (Group B, n = 30), or no scoliosis (Group C, n = 119). Adolescents with scoliosis (Groups A and B) repeated the questionnaires immediately after diagnosis and treatment recommendations (T2). Group B completed a third assessment 1-2 months after initial examination (T3).
At baseline, RSES and DASS 21 scores did not differ significantly between groups. Following diagnostic disclosure, Group A showed a significant decline in self-esteem, while both groups showed increases in stress, anxiety, and depression. In Group B, reassessed at T3, stress and anxiety decreased, whereas depression remained elevated relative to baseline.
AIS diagnosis was associated with a self-esteem decline that followed a pattern dependent on curve severity, with an immediate drop in mild AIS (Group A) versus a delayed decline emerging one to two months later in moderate/severe cases (Group B). Anxiety and depressive symptoms increased significantly in both groups, while stress increased significantly only in those with moderate/severe scoliosis (Group B). Routine screening of mental health after AIS diagnosis, alongside interdisciplinary care involving mental health professionals, may help identify vulnerable patients and enable timely psychosocial support.
Authors
Kaliterna Kaliterna, Buljan Buljan, Šegvić Šegvić, Čimić Čimić, Žuljević Žuljević
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