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.