Living with a visible difference can entail challenging social situations, associated with psychosocial symptoms. However, it is not clear whether adolescents with a visible difference experience more anxiety and depression than unaffected peers. We aim to determine whether adolescents with a visible difference experience more symptoms of anxiety and depression than unaffected peers. A literature search was conducted in Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, PsycINFO Ovid, and Google Scholar. Meta-analyses were done using random-effects models to calculate a standardised mean difference. Analyses for subgroups were used to study causes of visible difference. Eleven studies were identified (n = 1075, weighted mean age = 15.80). Compared to unaffected peers, adolescents with a visible difference experience more symptoms of anxiety (SMD = 0.253, 95 % CI [0.024, 0.482], p = .030), but not depression (SMD = 0.236, 95 % CI [−0.126, 0.599], p = .202). Adolescents with a skin condition did not experience more symptoms of anxiety (SMD = 0.149, 95 % CI [−0.070, 0.369], p = .182) or depression (SMD = 0.090, 95 % CI [−0.082, 0.262], p = .305) when compared to unaffected peers. Overall, more symptoms of anxiety are found in adolescents with a visible difference compared to peers. No differences in anxiety or depression were found for skin differences. Screening for anxiety is recommended.

Additional Metadata
Keywords Anxiety/anxiety disorders, Depression, SAD/social anxiety disorder/social phobia, Visible differences
Persistent URL dx.doi.org/10.1016/j.bodyim.2020.02.006, hdl.handle.net/1765/125029
Journal Body Image
Citation
van Dalen, M. (M.), Dierckx, B, Pasmans, S.G.M.A, Aendekerk, E.W.C. (E. W.C.), Mathijssen, I.M.J. (I. M.J.), Koudstaal, M.J, … Okkerse, J.M.E. (2020). Anxiety and depression in adolescents with a visible difference: A systematic review and meta-analysis. Body Image, 33, 38–46. doi:10.1016/j.bodyim.2020.02.006