B3781 - Identifying risk factors for adverse mental health outcomes in orofacial cleft and optimising interventions to avoid these - 17/05/2021

B number: 
B3781
Principal applicant name: 
Gemma Sharp | MRC IEU, UoB
Co-applicants: 
Dr Evie Stergiakouli
Title of project: 
Identifying risk factors for adverse mental health outcomes in orofacial cleft and optimising interventions to avoid these
Proposal summary: 

Children born with a cleft (gap) in the lip and/or palate face tough challenges throughout their lives. They undergo multiple operations and attend numerous clinical appointments, creating significant stress on children and their families. Many children experience facial disfigurement and difficulties making themselves understood, which can lead to teasing and low self-esteem. These children are particularly vulnerable to mental health issues, but it’s currently unclear how many children are at risk and how to identify them. With the COVID-19 pandemic introducing additional difficulties with delaying surgeries and disrupting schooling, we urgently need to develop a better understanding of which children are likely to need additional psychological support. Therefore, this research project aims to shed light on the pathways linking clefts to mental health problems. We will capitalise on our existing access to large-scale population-wide and clinical cohort studies, including the Cleft Collective cohort study, which is the world’s largest and most detailed longitudinal cohort study of children and families affected by cleft. In this established cohort, we will send additional questionnaires to collect more information as the children grow up and enter puberty, which is when mental health problems tend to emerge. Using these data, we will provide the first detailed description of mental health outcomes in children born with a cleft, and compare this to the same outcomes in children without a cleft IN THE ALSPAC COHORT and the Millennium Cohort Study. We will use state-of-the-art statistical approaches to study the contribution of genetic and environmental factors to shaping mental health in children born with a cleft, and we will use data from the Cleft Collective cohort study’s COVID-19 questionnaire to study the impact of the pandemic on these particularly vulnerable children, many of whom experienced delays in their surgeries. Finally, we will use our existing strong links to the NHS cleft teams and cleft charities to feed our findings directly into clinical decision making and policy to enable clinicians to plan provision to improve mental health outcomes for these children.

Impact of research: 
By capitalising on our access to large-scale population-wide and clinical cohort studies, our project will provide the first detailed description of neurodevelopmental and mental health outcomes in children born with CL/P. Using our expertise in genetic epidemiology and causal inference, we will explore the contributions of genetic, prenatal environmental, and downstream factors associated with having CL/P on mental health outcomes. Using existing data collected before and during the COVID-19 pandemic, we will study whether and how the COVID-19 situation has affected the mental health and wellbeing of this paediatric population. Finally, through our established, strong network of NHS and charity stakeholders, our scientific insights will be fed directly into clinical decision making and policy. Therefore, our research will make a valuable contribution to improving mental health and neurodevelopmental outcomes for this vulnerable population of children.
Date proposal received: 
Tuesday, 11 May, 2021
Date proposal approved: 
Monday, 17 May, 2021
Keywords: 
Mental health - Psychology, Psychiatry, Cognition, Mental health, child behaviour and mental health