Multidimensional psychosocial characteristics of adolescents with idiopathic scoliosis in China: a controlled cross-sectional study

BACKGROUND: Adolescent idiopathic scoliosis (AIS) is the most common musculoskeletal disorder affecting adolescents. Despite its multifaceted implications, healthcare professionals often prioritise correcting spinal deformities over addressing the psychological ramifications. Our study aimed to comprehensively examine the psychosocial characteristics and mental health outcomes of adolescents with AIS in China. METHODS: We recruited 61 participants with AIS and 61 healthy controls aged 10–18 years. Mental health status, psychosocial behaviour, and health-related quality of life (HRQoL) were evaluated using self-reported versions of the Strengths and Difficulties Questionnaire (SDQ-S), Self-rating Anxiety Scale (SAS), nine-item Patient Health Questionnaire (PHQ-9), and Scoliosis Research Society-22 Questionnaire (SRS-22). The Shapiro-Wilk normality test and Levene’s test were used to measure the normality and homogeneity of variance of each dependent variable, respectively. For p-values of > 0.05, an independent-sample t-test was used to identify any significant differences between participants with AIS and healthy controls. For p-values of < 0.05, the Mann-Whitney U-test was performed. The chi-square test was used to compare differences in dichotomous variables. Pearson and Spearman correlation analyses were used to test the correlations between continuous and ordinal categorical variables. Statistical significance was set at p-values of < 0.05. RESULTS: The psychosocial behaviour and mental status-related domains of SRS-22 and SDQ-S differed significantly between adolescents with AIS and healthy controls in China. The SAS results showed that AIS participants had notably higher anxiety levels compared to controls. The Cobb angle significantly correlated with the function domain scores, SRS-22 scores, and anxiety levels of adolescents with AIS in China. CONCLUSIONS: AIS impairs the mental status and psychosocial behaviour of adolescents, significantly reducing their HRQoL. Regardless of scoliosis type, a large Cobb angle leads to increased anxiety in adolescents with AIS rather than depression. This highlights that early mental health evaluations and interventions for Chinese adolescents with AIS are crucial. TRIAL REGISTRATION: This observational study was registered in the Chinese Clinical Trial Registry ( https://www.chictr.org.cn/ ) on August 12, 2024, under the registration number ChiCTR2400088100.