A longitudinal study on the mental health status of young and middle-aged orthodontic patients

OBJECTIVES: To assess the mental health trajectory and its influencing factors in young and middle-aged orthodontic patients. METHODS: In a longitudinal study, 154 patients were recruited from Nantong Stomatological Hospital (March 2023-October 2024). A 1:1 propensity score matching (PSM) control cohort was established to balance demographic characteristics. Data on general information, social support (Social Support Rating Scale), and psychological distress (Kessler 10 scale) were collected at eight time points from treatment initiation to 15 months. Mental health trajectories were analyzed using generalized estimating equations (GEE). RESULTS: The GEE model indicated a significant temporal trend in mental health scores (Wald χ² = 304.51, p < 0.001). Significant factors included female gender (β = 6.12, p < 0.001), student status (β = 2.18, p = 0.020), higher monthly household income (>10,000 RMB (China's currency): β = -3.51, p < 0.001), higher education (Bachelor's degree or above: β = -1.89, p < 0.001), unmarried status (β = 3.05, p = 0.010), severe malocclusion (Class III: β = 1.23, p = 0.018), and social support (β = -0.35, p < 0.001), which was a protective factor. CONCLUSIONS: The mental health of young and middle-aged orthodontic patients follows a dynamic trajectory, associated with a combination of sociodemographic and clinical factors. Patients who are female, students, unmarried, or have severe malocclusion are at higher risk, whereas strong social support is protective. These findings highlight the need for timely psychological monitoring and personalized interventions for at-risk individuals throughout orthodontic care.