# Psychological Impact of Congenital Chest Wall Deformities Among Adolescents and Young Adults

## TL;DR

Adolescents and young adults with chest wall deformities face significant psychological challenges, which can be improved through surgical or non-surgical treatments.

## Contribution

This paper emphasizes the importance of psychosocial screening and support in treating chest wall deformities, beyond anatomical and physiological considerations.

## Key findings

- Adolescents with pectus excavatum and pectus carinatum experience impaired body image, social anxiety, and low quality of life.
- Corrective treatments improve self-esteem, social participation, and mental health with long-term benefits.
- Psychological burden should be considered alongside anatomical criteria in clinical decision-making and insurance coverage.

## Abstract

What are the main findings?
Psychosocial burden, including impaired body image, social anxiety, and low quality of life, is significant in adolescents and young adults with pectus excavatum and pectus carinatum, often manifesting as social avoidance, concealment behaviors, and emotional distress.Surgical and non-surgical correction of chest wall deformities markedly improves body image, self-esteem, social participation, and mental health scores, with benefits sustained long-term.

Psychosocial burden, including impaired body image, social anxiety, and low quality of life, is significant in adolescents and young adults with pectus excavatum and pectus carinatum, often manifesting as social avoidance, concealment behaviors, and emotional distress.

Surgical and non-surgical correction of chest wall deformities markedly improves body image, self-esteem, social participation, and mental health scores, with benefits sustained long-term.

What are the implications of the main findings?
Routine psychosocial screening and incorporation of psychologists into chest wall deformity clinics are essential for optimizing outcomes.Expansion of insurance coverage beyond anatomic criteria to include psychological indications can help mitigate long-term emotional distress.

Routine psychosocial screening and incorporation of psychologists into chest wall deformity clinics are essential for optimizing outcomes.

Expansion of insurance coverage beyond anatomic criteria to include psychological indications can help mitigate long-term emotional distress.

Progression of pectus excavatum and carinatum coincides with adolescence, a critical period for identity and self-esteem development. While clinical decision-making and insurance coverage have historically emphasized anatomic severity and cardiopulmonary functioning, increasing evidence suggests that psychosocial burden and quality of life (QoL) impairment represent central components of disease impact. A narrative review was conducted using the PubMed database to synthesize the current literature on the psychological impact of these deformities in adolescents and young adults, including body image distress, social functioning, and mental health effects before and after surgical and non-surgical correction, focusing on validated tools and qualitative studies. Across multiple cohorts, adolescents and young adults with chest wall deformities consistently report impaired body image, reduced self-esteem, social avoidance, and diminished QoL, even in the absence of diagnosable psychiatric disorders. Surgical and non-surgical corrections have positive effects in these domains. Psychological burden, therefore, represents a clinically meaningful component of chest wall deformities and should be considered alongside anatomic and physiologic criteria. Current evidence advocates for the integration of standardized psychosocial screening and support into evaluation and follow-up, which is essential for providing comprehensive, patient-centered care. Greater recognition of psychosocial outcomes may inform advocacy for broader treatment criteria, increasing accessibility among affected individuals.