{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T08:05:20Z","timestamp":1782979520836,"version":"3.54.5"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005332","name":"Alpha Omega Alpha Honor Medical Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005332","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000072","name":"National Institute of Dental and Craniofacial Research","doi-asserted-by":"publisher","award":["5T32DC005360"],"award-info":[{"award-number":["5T32DC005360"]}],"id":[{"id":"10.13039\/100000072","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["NIHT32\u2010GM008719"],"award-info":[{"award-number":["NIHT32\u2010GM008719"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005995","name":"Wisconsin Historical Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005995","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005995","name":"Wisconsin Historical Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005995","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Facial dysmorphic disorder (FDD), a variant of body dysmorphic disorder, occurs when individuals are preoccupied with perceived defects in their facial appearance. Cleft lip and\/or palate (CL\/P) requires many clinical interventions and has significant psychological impacts on a patient's perception of appearance. This study identified psychological burdens related to living as an adult with CL\/P and characterizes the degree of FDD symptoms in an adult craniofacial population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, single\u2010center, cross\u2010sectional case\u2013control study using semi\u2010structured interviews and symptom assessments at a university\u2010based craniofacial center. Patients without CL\/P undergoing non\u2010cosmetic facial surgery were recruited as controls (<jats:italic>n<\/jats:italic>\u00a0=\u200920). Patients with an orofacial cleft (<jats:italic>n<\/jats:italic> = 30) were recruited from medical and dental providers at the University of North Carolina. Body Dysmorphic Disorder\u2010Yale Brown Obsessive Compulsive Scale (BBD\u2010YBOCS) scores were collected from a control population and patients with CL\/P to assess FDD severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Demographic factors such age, biological sex, and ethnicity had no significant impact on FDD symptom scores. Patient with CL\/P were more likely to have significant FDD symptoms (BDD\u2010YBOCS greater than 16) than patients without CL\/P (OR 10.5, CI<jats:sub>95<\/jats:sub> 2.7\u201341.1), and had a mean difference in FDD symptoms scores of 10.04 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.0001; CI<jats:sub>95<\/jats:sub> 5.5\u201314.6). Patients with CL\/P seen by a mental health provider in the past 3\u2009months had 3\u2010fold lower overall FDD symptom scores (OR 0.081; CI<jats:sub>95<\/jats:sub> 0.0085\u20130.77).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adults with CL\/P would benefit from treatment for cleft\u2010specific needs and psychological support as they face unique stressors related to their appearance, including an increase in FDD\u2010associated symptoms. This study emphasizes the importance of recognizing psychological symptoms and providing ongoing multidisciplinary care to adults with CL\/P.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3; Individual case\u2013control study <jats:italic>Laryngoscope<\/jats:italic>, 133:818\u2013821, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30378","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T11:03:21Z","timestamp":1662116601000},"page":"818-821","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Body Dysmorphic Disorder in Adult Patients With an Orofacial Cleft: An Unseen Psychological Burden"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2213-1872","authenticated-orcid":false,"given":"Wesley H.","family":"Stepp","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva J.","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1895-318X","authenticated-orcid":false,"given":"Michael W.","family":"Canfarotta","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeyhan","family":"Wood","sequence":"additional","affiliation":[{"name":"University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry  Chapel Hill North Carolina U.S.A."},{"name":"Department of Surgery University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Vandoros","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot","family":"Stein","sequence":"additional","affiliation":[{"name":"University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renie","family":"Daniel","sequence":"additional","affiliation":[{"name":"University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry  Chapel Hill North Carolina U.S.A."},{"name":"Department of Oral and Maxillofacial Surgery University of North Carolina, School of Dentistry  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W.","family":"Shockley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph Madison","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia F.","family":"Drake","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of North Carolina, School of Medicine  Chapel Hill North Carolina U.S.A."},{"name":"University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry  Chapel Hill North Carolina 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