The Incidence of Underlying Mental Health Disorders in a Facial Synkinesis Population

Synkinesis is estimated to impact 10% to 50% of those with facial palsy. We aim to identify the incidence and factors associated with anxiety and depression in the facial synkinesis population.

Prospective cohort study.

Patients aged 18 and older with a diagnosis of facial synkinesis at a tertiary medical center were eligible for inclusion.

Demographic variables were collected, and the following surveys were distributed: Synkinesis Assessment Questionnaire, Facial Clinimetric Evaluation Scale, Facial Disability Index, Center for Epidemiological Studies Depression Scale, and Fear of Negative Appearance Evaluation Scale. Patient videos were graded for physician perceived severity using the Electronic Facial Paralysis Assessment and Sunnybrook scale. Analysis of the overall incidence of anxiety and depression symptoms as well as the impact of demographic factors was performed using Pearson product moment correlation and regression modeling.

One-hundred patients met inclusion criteria. Over 25% of patients met criteria for possible or probable depression and the most common appearance-related anxiety score was 30, indicating severe anxiety. Female gender, younger age, and previous history of anxiety and depression were associated with increased depression and anxiety scores at baseline with shorter duration of synkinesis also trending toward higher scores. Worse patient reported severity was also associated with increased depression and appearance-related anxiety scores.

The overall prevalence of depression and appearance-related anxiety is relatively high in patients with facial synkinesis.