Purpose: In children and youth, the prevalence of psychiatric disorder associated with chronic medical illness approximates 30%. The impact of psychiatric disorder on the management of scoliosis has not been well explored in the literature. The objective of this study was to estimate the prevalence of mental health disorders in patients with adolescent idiopathic scoliosis (AIS).

Method: Adolescents being treated for AIS completed the Achenbach Youth Self-Report and one parent completed the Achenbach Child Behaviour Checklist. Both measures are validated for screening of mental health disorders. The prevalence of mental health disorder in this population was estimated on the basis of the proportion that screened positive. Univariate analysis and logistic regression analysis was conducted to estimate the association between variables. A sensitivity analysis was performed to estimate the robustness of the results.

Results: Between October 2006 and February 2008, 61 of 126 adolescents completed the study (48%). Of the 61 subjects, 18 were treated with observation, 26 with bracing, and 17 with surgical intervention. Overall, there were 41 adolescents who screened positive (67%). Sensitivity analysis demonstrated that, of those who did not return the questionnaire, the prevalence of a positive screen would have had to have been less than 0.1% in order to decrease the overall prevalence to 30%. There was a statistically significant difference in the magnitude of the scoliosis between those who screened positive (mean curve magnitude 39 degrees) compared to those who screened negative (mean curve magnitude 30.6 degrees) (p=0.03).

Conclusion: The estimated prevalence of a mental health disorder using the Achenbach questionnaires in patients with AIS is 67%. This is substantially higher than the anticipated prevalence in either the healthy population or those with a chronic illness. The results of this study provide evidence of the high burden of mental health illness amongst those with AIS. The sensitivity analysis demonstrated that the results are robust despite the relatively low response rate.