Oxford Facial Palsy Service, Oxford University Hospitals NHS Foundation Trust, UK.
Centre for Appearance Research, University of the West of England, UK.
Br J Health Psychol. 2020 Sep;25(3):695-727. doi: 10.1111/bjhp.12440. Epub 2020 Jun 15.
Facial palsy is a condition which can lead to significant changes in facial function and appearance. People with facial palsy often report psychosocial difficulties, including withdrawal from social activities, anxiety, negative body image, and low mood. This paper aimed to review all published research investigating the psychosocial impact of facial palsy on adults.
A systematic search of MEDLINE, CINAHL, EMBASE, PsycINFO, and AMED databases was performed. The quality of included studies was assessed, and data were extracted with regard to characteristics of participants; study methodology and design; outcome measures used; and psychosocial outcomes.
Twenty-seven studies met inclusion criteria. A high proportion of people with facial palsy reported clinically significant levels of anxiety and depression, with greater difficulties typically reported by females, compared to males. Other difficulties consistently reported include low quality of life, poor social function, and high levels of appearance-related distress. Objective severity of facial palsy was consistently shown to not be associated with anxiety or depression, with psychological factors instead likely mediating the relationship between the severity of facial palsy and psychosocial well-being.
Irrespective of objective symptom severity, facial palsy has the potential to have a significant impact on psychosocial well-being and quality of life. The various methodological limitations of the included studies are discussed, along with clinical implications, including the need for greater access to psychological screening and interventions for people with facial palsy.
面瘫是一种可能导致面部功能和外观发生重大变化的疾病。面瘫患者常报告存在社会心理困难，包括回避社交活动、焦虑、负面身体形象和情绪低落。本文旨在综述所有已发表的研究面瘫对成年人的社会心理影响。
对 MEDLINE、CINAHL、EMBASE、PsycINFO 和 AMED 数据库进行了系统检索。评估了纳入研究的质量，并提取了有关参与者特征、研究方法和设计、使用的结局测量以及社会心理结局的数据。
符合纳入标准的研究有 27 项。相当一部分面瘫患者报告存在临床显著程度的焦虑和抑郁，女性比男性更常见。其他经常报告的困难包括生活质量差、社会功能差和与外貌相关的困扰程度高。面瘫的客观严重程度始终与焦虑或抑郁无关，心理因素可能在面瘫严重程度与社会心理健康之间的关系中起中介作用。
无论客观症状严重程度如何，面瘫都有可能对面部功能和生活质量产生重大影响。讨论了纳入研究的各种方法学局限性，以及临床意义，包括需要为面瘫患者提供更多的心理筛查和干预机会。
