Socioeconomic, Personality Factors Found to Impact Quality of Life for Patients With Facial Palsy

Researchers found that the factors most associated with health related quality of life (HRQOL) in patients with facial palsy are age, bilateral facial palsy, severity of facial palsy, anxiety, and key personality traits, including extraversion and emotional stability.

“This study provides insight into factors that are important when measuring HRQOL in patients with facial palsy,” the researchers said.

Additional factors examined in the study included duration of facial palsy, cause, marital status, education level, occupational status, monthly income, and 5 personality traits (extraversion, agreeableness, conscientiousness, emotional stability, and openness to experiences). The study also looked at religious involvement and depression.

The 3 scales used to evaluate HRQOL in patients were the Facial Clinometric Evaluation (FaCE) Scale, the Facial Disability Index (FDI), and the Sunnybrook Facial Grading System. The FaCE and FDI scales are reported by patients with facial palsy, whereas the Sunnybrook Facial Grading System relies on clinician evaluations. The FDI is based on 2 aspects: social and physical function.

Although the Sunnybrook Facial Grading System was found to be associated with FDI physical scores, it was not found to be associated with FDI social scores. This suggests that a “distortion of the face as objectively graded by a clinician is less important than personality traits and unilateral or bilateral facial palsy when it comes to social function.”

The study supported the findings of another systematic review which found that personality traits characterized by positive affectivity, such as extraversion and emotional stability, were associated with higher HRQOL scores. Findings suggest that those with positive affectivity traits have more effective coping strategies.

No personality traits were found to be associated with FDI physical scores but 4 out of 5 of the traits assessed were associated with FDI social scores. This suggests that personality alters social consequences but not the perception of facial function.

Bilateral facial palsy was found to be negatively associated with FDI social scores. Researchers explained that those with bilateral facial palsy have a greater social disability due to the inability to express emotions by means of facial expression.

However, “perceived disability mainly depends on patients’ expectations and perceived control regarding the course of their condition,” the researchers noted.

Anxiety was found to alter the overall HRQOL but not specifically physical or social function. Depression was only found to be associated with FDI social scores.

Researchers suggest that, “it may be beneficial for patients when the clinician considers these factors in discussing facial palsy treatment because mental distress and personality traits are often overlooked.

Certain socioeconomic factors like age and facial function were found to be HRQOL predictors in previous studies. Although those findings were not supported in the new study, reasoning for this could be sample variation between the studies or the lack of skin elasticity for the elderly which can cause asymmetry in facial function.

Researchers noted “it is important to take these, and other factors identified in this study, into account in future research and treatment of patients with facial palsy.”

Reference

Bruins TE, van Veen MM, Mooibroek-Leeuwerke T, Werker PMN, Broekstra DC, Dijkstra PU. Association of socioeconomic, personality, and mental health factors with health-related quality of life in patients with facial palsy [published online February 13, 2020]. JAMA. doi: 10.1001/jamaoto.2019.4559.