Mental Health, Psychosocial Functioning and Quality of Life in Adolescents With Anorectal Malformation

Aim of the study: There is limited knowledge on mental health in adolescents with anorectal malformation (ARM). This study aimed to assess mental health, psychosocial functioning, and quality of life (QoL) in this population. Methods: Adolescents treated at Oslo University hospital were invited to participate. Patients with intellectual disability or cloaca were excluded. Mental health was assessed by interview (Child Assessment Schedule; CAS) and by questionnaires obtained from parents (Child Behavior Checklist; CBCL) and adolescents (Youth Self-Report; YSR). Psychosocial functioning was evaluated using the Child Global Assessment Scale (cGAS) and adolescent QoL with Pediatric Quality of Life inventory (PedsQL). Medical records reviewed for somatic history. Ethical approval was obtained. Results: Thirty-one of 41 (76 %) eligible adolescents, 17/31 (55 %) males, participated. Median age was 15 (12e18) years. Nine had perineal fistula, 16 rectovestibular/rektobulbar/rectoprostatic fistula, and 6 other ARM variants (web, atresia, unknown). Associated anomalies were recorded in 21/31 (72 %). Four had colostomy and 9 an appendicostomy. CAS interviews revealed that 11/31 (36 %) of participated adolescents met criteria for a mental health disorder mainly within the emotional (internalizing) categories (WHO report 2021; general population prevalence 14 %). Parents reported internalizing problems on CBCL in 5/31 (16 %), and 7/31 (23 %) adolescents reported internalizing problems on YSR. Based on interviewer-rated cGAS, 11/31 (26 %) scored in the clinical range. By PedsQL self-report 5/31 (16 %) reported reduced QoL. Conclusions: One in three met criteria for a mental health disorder and one in six reported reduced QoL among adolescents with ARM. Emotional problems were most common. Level of evidence: III. (c) 2025 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).