Peer bullying in adolescents with idiopathic scoliosis treated with bracing: a case–control study

This study aimed to evaluate peer bullying in patients with adolescent idiopathic scoliosis (AIS) treated with bracing and to examine associated self-esteem and social anxiety compared with age- and sex-matched healthy controls. This case-control study was conducted at a tertiary university hospital between January 2023 and June 2025. The brace group consisted of 31 adolescents (22 girls, 9 boys) with AIS treated with a Chêneau brace, of whom 24 were current and 7 were former brace users. The control group comprised 32 age- and sex-matched healthy adolescents (21 girls, 11 boys). Psychosocial assessment was performed using the Rosenberg Self-Esteem Scale (RSES), the Child and Adolescent Bullying Scale-9 Short Form (CABS-9), and the Social Anxiety Scale for Adolescents (SAS-A). Intergroup comparisons were analyzed with the Mann-Whitney U test, and correlations within the brace group were examined using Spearman’s correlation analysis. Current and former brace users were also analyzed separately in an exploratory analysis. The mean duration of brace use was 17.1 (± 10.2) months, the mean Cobb angle was 31.1° (± 4.4°), and the mean self-reported daily brace-wear time was 21.2 (± 1.2) hours. Adolescents in the brace group had significantly higher CABS-9 scores than controls (19.6 ± 5.9 vs. 12.5 ± 6.3, p < 0.001). CABS-9 scores were similar in current and former brace users ( p = 0.981), and both subgroups scored higher than controls. In contrast, RSES and SAS-A scores did not differ significantly between groups (RSES, p = 0.238; SAS-A, 50.8 ± 11.0 vs. 51.3 ± 10.2, p = 0.826). Within the brace group, brace duration was positively correlated with CABS-9 scores ( r = 0.397, p = 0.027), while age was negatively correlated with SAS-A scores ( r =-0.396, p = 0.027). Adolescents with AIS treated with bracing had significantly greater exposure to peer bullying than healthy controls, while social anxiety and self-esteem did not differ significantly between groups. In exploratory analyses, longer brace duration was associated with greater bullying exposure, and younger age was associated with higher social anxiety within the brace group. Because no non-braced AIS group was included, these findings cannot distinguish the effect of bracing from that of scoliosis itself. These findings support specific attention to peer bullying during routine follow-up of adolescents receiving brace treatment for AIS.