Adolescent idiopathic scoliosis and comorbid anxiety and depression: advances in psychophysiological interaction mechanisms and integrated interventions

Adolescent Idiopathic Scoliosis (AIS) is a common three-dimensional spinal deformity, and its comorbidity with psychological disorders such as anxiety and depression is increasingly attracting clinical and research attention. This narrative review aims to summarize the epidemiological characteristics of this comorbidity in AIS. It explores the complex underlying psychophysiological interaction mechanisms, including psychosocial stress, chronic pain, body image disturbance, and interconnected neuroendocrine and neuroimmune pathways. Based on this mechanistic understanding, the article further synthesizes and evaluates existing intervention strategies for this comorbid condition, encompassing psychological therapies, pharmacotherapy, physical rehabilitation, and emerging multidisciplinary integrated care models. Finally, the review outlines future research directions, with the goal of providing a theoretical foundation and a comprehensive management framework to improve the holistic physical and mental health outcomes for individuals with AIS.