Cleft Lip and/or Palate Is Associated with an Increased Prevalence of Mental Health and Behavioral Disorders

Objective: To evaluate the prevalence of mental health and behavioral disorders in individuals with cleft lip and/or palate (CL/P) versus the general population. Design: Retrospective cohort study. Cohorts of people with CL/P ≤ 18 and >18 years of age were compared to controls matched for age and sex. Setting: 92 healthcare organizations. Patients, Participants: The TriNetX Research Network was queried for pediatric and adult participants using diagnosis and procedure codes from 2011 to 2021. Main Outcome Measure(s): Rates of mental health disorders and prescriptions for mental health medications and stimulants. Results: Pediatric (n = 45,341) and adult (n = 10,855) individuals with CL/P were significantly more likely than controls to have depressive episodes, anxiety disorders, attention-deficit hyperactivity disorders, and disruptive disorders, and be prescribed mental health medications and stimulants (all P < .001). Relative risks compared to controls for mental health diagnoses and medications ranged from 2.32 to 5.47 for pediatric participants and from 1.26 to 10.79 for adults. Pediatric participants with a cleft palate with or without a cleft lip and associated conductive hearing loss (CHL) or otitis media with effusion (OME) showed higher rates of disorders and prescriptions compared to those without CHL/OME (all P < .001). Conclusions: CL/P, especially when associated with OME/CHL, was associated with a significantly higher prevalence of mental health and behavioral disorders. These effects were present across age groups, underscoring the need for early intervention strategies and long-term mental health support for individuals with CL/P.