Mental health and quality of life of parents of children with clubfoot during the first year of treatment: a multicentre prospective controlled study

Clubfoot is a common congenital musculoskeletal deformity requiring prolonged treatment with the Ponseti method. Diagnosis and treatment may impose psychological burden on caregivers and potentially affect treatment adherence. This prospective controlled study assessed perceived stress, anxiety, depression, and quality of life among parents of children with clubfoot from treatment initiation until the child reached one year of age. A multicentre prospective controlled study was conducted in five Hungarian clubfoot treatment centres between July 2022 and June 2024. Parents of children with isolated clubfoot were compared with parents of children attending developmental hip screening. Participants completed questionnaires at treatment initiation, approximately three months later, and at one-year follow-up. Psychological outcomes were assessed using the Perceived Stress Scale, State-Trait Anxiety Inventory–State subscale, Beck Depression Inventory, and Short Form-36 Health Survey. Between-group comparisons were performed using the Mann–Whitney U test and Fisher’s exact test. Longitudinal changes were evaluated using the Wilcoxon signed-rank test. Associations between variables were examined using Spearman correlation and robust regression analyses. At baseline, 59 parents in the clubfoot group and 155 controls participated. Parents of children with clubfoot reported significantly higher perceived stress, anxiety, and depressive symptoms than controls. Median perceived stress scores were higher in the clubfoot group (26 vs. 22, p = 0.001), as were anxiety scores (47 vs. 35, p < 0.001) and depression scores (8 vs. 5, p = 0.001). Psychological outcomes improved significantly during follow-up, and no significant differences between groups remained at one year. Parents in the clubfoot group initially reported poorer quality of life across several mental health domains, but these differences resolved during follow-up. Higher stress levels were associated with participation in clubfoot-related social media groups, prenatal orthopaedic consultation, and lower educational attainment. Perceived stress correlated strongly with anxiety and moderately with depressive symptoms. Parents of children with clubfoot experience substantial psychological distress during the early stages of treatment, but most measures improve considerably during the first year. Early psychological support, parental education, and targeted identification of vulnerable families may improve caregiver well-being and support successful treatment adherence. Retrospectively registered: OSF Registries, registered on 10th June 2026.