Health-related Quality of Life and Psychiatric Morbidity among Children and Adolescents with Cleft Lip and/or Palate and Their Mothers Attending the Cleft Clinic at the Armed Forces Specialist Hospital, Kano, Northwest Nigeria

Background: Cleft lip and/or palate (CL/P) is a common congenital anomaly with far-reaching implications on health-related quality of life (HRQoL) and psychological well-being. While surgical repair improves functional outcomes, its impact on psychiatric morbidity and psychosocial functioning, especially in low-resource settings, is underexplored. Objective: The objective of this study was to assess the HRQoL and psychiatric morbidity among children and adolescents with CL/P and their mothers, before and after surgical intervention at a Nigerian cleft care facility. Materials and Methods: A longitudinal study involving 250 mother–child dyads attending the cleft clinic at the Armed Forces Specialist Hospital, Kano. Validated tools (Pediatric Quality of Life Inventory, World Health Organization Quality of Life-BREF, MINI, Mini-International Neuropsychiatric Interview for Children and Adolescents, CRAFFT, and Drug Use Disorders Identification Test) were used to assess HRQoL and psychiatric morbidity pre- and 6 months postsurgery. Data were analyzed using McNemar’s test, Chi-square, and logistic regression. Results: Presurgical psychiatric morbidity was high among mothers (depression: 46%, anxiety: 42%, posttraumatic stress disorder [PTSD]: 32%, suicidality: 14%, and substance use: 26%) and children (depression: 20%, anxiety: 22%, PTSD: 16%, suicidality: 12%, substance use: 24%, and body dysmorphic disorder: 46.7% among those > 10 years), with 60%–68% experiencing poor HRQoL. Postsurgical outcomes showed statistically significant improvements across all HRQoL domains and reductions in psychiatric symptoms ( P < 0.001). Predictors of poor outcomes included combined cleft type, low socioeconomic status, maternal education, and social stigma. Notably, poor maternal HRQoL independently predicted child depression (adjusted odds ratio = 2.95). Conclusion: Surgical repair significantly enhances HRQoL and reduces psychiatric morbidity. However, psychosocial vulnerability persists. Integrating mental health services into cleft care is essential for holistic rehabilitation in resource-constrained settings.