{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:40:22Z","timestamp":1785465622769,"version":"3.56.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002014"],"award-info":[{"award-number":["UL1 TR002014"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the prevalence of mental health and behavioral disorders in individuals with cleft lip and\/or palate (CL\/P) versus the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study. Cohorts of people with CL\/P\u2009\u2264\u200918 and &gt;18 years of age were compared to controls matched for age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>92 healthcare organizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>The TriNetX Research Network was queried for pediatric and adult participants using diagnosis and procedure codes from 2011 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Rates of mental health disorders and prescriptions for mental health medications and stimulants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pediatric (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200945,341) and adult (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200910,855) individuals with CL\/P were significantly more likely than controls to have depressive episodes, anxiety disorders, attention-deficit hyperactivity disorders, and disruptive disorders, and be prescribed mental health medications and stimulants (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Relative risks compared to controls for mental health diagnoses and medications ranged from 2.32 to 5.47 for pediatric participants and from 1.26 to 10.79 for adults. Pediatric participants with a cleft palate with or without a cleft lip and associated conductive hearing loss (CHL) or otitis media with effusion (OME) showed higher rates of disorders and prescriptions compared to those without CHL\/OME (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CL\/P, especially when associated with OME\/CHL, was associated with a significantly higher prevalence of mental health and behavioral disorders. These effects were present across age groups, underscoring the need for early intervention strategies and long-term mental health support for individuals with CL\/P.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251331329","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T03:45:32Z","timestamp":1745984732000},"page":"1285-1296","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Cleft Lip and\/or Palate Is Associated with an Increased Prevalence of Mental Health and Behavioral Disorders"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5902-7054","authenticated-orcid":false,"given":"F. Jeffrey","family":"Lorenz","sequence":"first","affiliation":[{"name":"Penn State Hershey Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Ma","sequence":"additional","affiliation":[{"name":"Penn State Hershey Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniruddha C.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Penn State Hershey Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessyka G.","family":"Lighthall","sequence":"additional","affiliation":[{"name":"Penn State Hershey Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-60826-8.00005-5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31822e5e4d"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0022034508327868"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60695-4"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/562892"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/20.4.407"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1999_036_0001_piiccs2.3.co_2"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtumed.2018.04.007"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/13591045231200665"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156261"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2018.06.024"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1024"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-005306"},{"issue":"4","key":"e_1_3_2_15_2","article-title":"Speech, language, voice, resonance and hearing disorders in patients with cleft lip and palate","volume":"96","author":"Prathanee B","year":"2013","unstructured":"Prathanee B, Thanawirattananit P, Thanaviratananich S. Speech, language, voice, resonance and hearing disorders in patients with cleft lip and palate. J Med Assoc Thai. 2013;96(Suppl 4):S71\u2010S80. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24386745","journal-title":"J Med Assoc Thai"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(87)80348-7"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.44.1.35"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03218.x"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.10986"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1200\/CCI.17.00067"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200303000-00015"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1277715"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_2003_040_0310_conbip_2.0.co_2"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/1359104503008001003"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.14856"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.04.024"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00238-020-01633-z"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1080\/028443102753478327"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2005.03.004"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656211028494"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221125377"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656241305889"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1998_035_0127_ldsaag_2.3.co_2"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.02.002"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2013.07.015"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003446-198602000-00008"},{"issue":"3","key":"e_1_3_2_37_2","first-page":"171","article-title":"Cleft palate and otitis media with effusion: A review","volume":"124","author":"Sheahan P","year":"2003","unstructured":"Sheahan P, Blayney AW. Cleft palate and otitis media with effusion: A review. Rev Laryngol Otol Rhinol (Bord). 2003;124(3):171\u2010177. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/14725133","journal-title":"Rev Laryngol Otol Rhinol (Bord)"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2011.603303"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656251331329","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10556656251331329","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656251331329","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:22:35Z","timestamp":1777393355000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10556656251331329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":37,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/10556656251331329"],"URL":"https:\/\/doi.org\/10.1177\/10556656251331329","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,30]]}}}