Impact of Craniofacial Scars on Psychological Status in Patients: A Cross-Sectional Study

OBJECTIVE: To investigate the association between craniofacial scar severity and psychological status in patients with craniofacial scars. METHODS: This cross-sectional study enrolled adult patients with craniofacial scars. Scar severity was objectively assessed using the Vancouver Scar Scale (VSS), while depressive and anxiety symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Multivariable linear regression analyses were performed to examine the associations between scar severity and psychological outcomes, adjusting for age, sex, scar etiology, scar location, time since injury, appearance-exposed occupation, prior psychological history, and previous scar treatment. RESULTS: After multivariable adjustment, higher VSS scores were significantly associated with higher PHQ-9 and GAD-7 scores. Time since injury showed a negative association with both depressive and anxiety symptom scores. Other demographic and clinical variables were not significantly associated with psychological outcomes after adjustment. CONCLUSION: Greater objective severity of craniofacial scars may be associated with increased depressive and anxiety symptoms. These findings highlight the importance of psychological assessment and appropriate support in the comprehensive management of patients with craniofacial scars.