Khalid Uzair, Majeed Nida, Chovaz Cathy J, Choudhary Fahad Riaz, Munawa Khadeeja
Department of Psychiatry, Bahawal Victoria Hospital, Quaid-E-Azam Medical College, Bahawalpur, Punjab, Pakistan.
Department of Psychology, Government College University, Lahore, Punjab, Pakistan.
Eur Child Adolesc Psychiatry. 2025 Jun 26. doi: 10.1007/s00787-025-02795-6.
This systematic review aimed to assess the mental health of children and adolescents who are Deaf or Hard of Hearing (DHH), including those with moderate to profound levels of hearing loss, exploring factors influencing their psychological well-being and social functioning.
Following PRISMA guidelines, a comprehensive search was conducted in nine databases (Medline, PubMed, PsycINFO, etc.) up to January 2025. Empirical qualitative, quantitative, and mixed-methods studies published in English were included, with 46 studies selected after screening. Study quality was assessed using a 14-criteria scoring system. Data extraction was performed by the first author and validated by co-authors.
A total of 46 studies with 22,859 participants (ages 6-21) were included. Findings revealed that individuals who are DHH or moderate to profound hearing loss experience higher rates of internalizing disorders, such as anxiety and depression, compared to hearing peers. Social exclusion, communication barriers, and stigma were significant risk factors. Mainstream schools exacerbated mental health challenges, whereas specialized schools provided a supportive environment. Early diagnosis and intervention, especially cochlear implants, improved psychosocial development. Communication proficiency, especially sign language, positively impacted quality of life and mental health. Parental involvement and targeted interventions helped mitigate behavioral challenges and executive functioning deficits.
This review highlights the key factors affecting the mental health of DHH youth, including communication methods, educational setting, early intervention, and social relationships. Tailored interventions addressing these factors are essential for improving psychosocial development. Future research should focus on developing and testing interventions to enhance the mental health and well-being of individuals who are DHH or have moderate to profound hearing loss.
本系统评价旨在评估失聪或听力障碍（DHH）儿童和青少年的心理健康状况，包括中度至重度听力损失者，探讨影响其心理健康和社会功能的因素。
遵循PRISMA指南，截至2025年1月，在九个数据库（Medline、PubMed、PsycINFO等）中进行了全面检索。纳入以英文发表的实证性定性、定量和混合方法研究，筛选后选取了46项研究。使用14项标准评分系统评估研究质量。数据提取由第一作者进行，并经共同作者验证。
共纳入46项研究，涉及22,859名参与者（年龄6至21岁）。研究结果显示，与听力正常的同龄人相比，失聪或中度至重度听力损失的个体内化障碍（如焦虑和抑郁）的发生率更高。社会排斥、沟通障碍和耻辱感是显著的风险因素。主流学校加剧了心理健康挑战，而特殊学校提供了支持性环境。早期诊断和干预，尤其是人工耳蜗植入，改善了心理社会发展。沟通能力，尤其是手语，对生活质量和心理健康产生了积极影响。父母参与和针对性干预有助于减轻行为挑战和执行功能缺陷。
本综述强调了影响失聪或听力障碍青少年心理健康的关键因素，包括沟通方式、教育环境、早期干预和社会关系。针对这些因素的量身定制干预对于改善心理社会发展至关重要。未来的研究应侧重于开发和测试干预措施，以提高失聪或听力障碍个体或中度至重度听力损失者的心理健康和幸福感。
