Psychiatric, Behavioral, and Medication Outcomes in Patients with Microtia

Objective: To compare the prevalence of mental health and behavioral disorders and related prescriptions among pediatric and adult patients with microtia versus matched controls. Design: Retrospective cohort study. Setting: Data were obtained from the TriNetX Research Network, comprising more than 80 healthcare organizations across the United States. Patients, Participants: Pediatric and adult patients diagnosed with microtia were identified and matched to control cohorts without microtia. The pediatric cohort included 12 369 patients per group, and the adult cohort included 1 772 patients per group. Intervention: Subgroup analysis evaluated the impact of surgical intervention for microtia in the pediatric population. Main Outcome Measures: Diagnoses of depression, anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), conduct disorders, and prescriptions for mental health and stimulant medications. Results: In the pediatric cohort, patients with microtia demonstrated higher risks of anxiety disorders (RR: 1.29; CI: 1.05-1.59; p = .016), conduct disorders (RR: 1.34; CI: 1.00-1.79; p = .046), and mental health prescriptions (RR: 1.51; CI: 1.25-1.83; p < .0001). Among adults, microtia was associated with increased risk of anxiety (RR: 2.95; CI: 2.19-3.97; p < .0001), mental health prescriptions (RR: 1.87; CI: 1.55-2.26; p < .0001), and stimulant prescriptions (RR: 1.91; CI: 1.15-3.18; p = .0116). Surgical intervention in pediatric patients was protective against anxiety, ADHD, and disruptive disorders. Conclusions: Microtia, like other congenital facial deformities, showed a higher association with increased prevalence of several mental health disorders and related medication use, with effects more pronounced in adulthood. Surgical intervention may mitigate certain psychiatric risks in pediatric patients.