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.