@article{ref1,
title="The association of affective disorders and facial scarring: systematic review and meta-analysis",
journal="Journal of affective disorders",
year="2018",
author="Gibson, John Alexander Gerald and Ackling, Edward and Bisson, Jonathan I. and Dobbs, Thomas D. and Whitaker, Iain S.",
volume="239",
number="",
pages="1-10",
abstract="BACKGROUND: Facial scarring can have a dramatic effect on a patient's psychological health and wellbeing and present unique management challenges. This patient population remains poorly characterised in the contemporary literature. AIMS: To evaluate the prevalence of, and risk factors associated with affective disorders in adult patients with facial scars. <br><br>METHODS: A systematic review was conducted using a protocol registered with PROSPERO and in line with the PRISMA statement. A comprehensive search of the literature was conducted using PubMed, MEDLINE, EMBASE, PSYCHInfo and The Cochrane Library. <br><br>RESULTS: Twenty one studies were included, with a total of 2,394 participants. Using a random effects model, the weighted pooled prevalence of anxiety was 26.1% (95% CI 17.9%-36.3%) and the weighted pooled prevalence of depression was 21.4% (95% CI 15.4%-29.0%). Studies identified female gender, past psychiatric history and violent causation as factors associated with anxiety and depression. LIMITATIONS: Included studies were limited to those published in peer reviewed journals. Longitudinal trends in both anxiety and depression were limited by a short duration of follow up. <br><br>CONCLUSIONS: There is a high and persistent burden of affective disorders in patients with facial scars. Additional research is required to further characterise this population and develop effective management strategies.<br><br>Copyright © 2018. Published by Elsevier B.V.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2018.06.013",
url="http://dx.doi.org/10.1016/j.jad.2018.06.013"
}