A narrative review of psychological distress and psychosocial burden in adolescent idiopathic scoliosis

Purpose Adolescent idiopathic scoliosis (AIS) is commonly managed as a structural spinal condition, but mental health and psychosocial concerns have also been reported in affected adolescents. This review aimed to summarize these outcomes and examine associated biological, psychological, and social factors within a conceptual biopsychosocial framework. Methods PubMed/MEDLINE and Google Scholar were searched for relevant studies, and reference lists of relevant articles were screened for additional literature. Studies reporting mental health, psychological, psychosocial, psychiatric, or related health-related quality-of-life outcomes in adolescents with AIS were considered. Findings were summarized narratively. Results Studies suggest that some adolescents with AIS may experience anxiety and depressive symptoms, psychological distress, psychiatric conditions, body- and self-image concerns, and reduced health-related quality of life. The frequency and severity of these outcomes varied across study populations and assessment methods, and associations with radiographic severity were inconsistent. Body and self-image, pain, and treatment-related stress were commonly associated with mental health outcomes. Catastrophizing, coping, resilience, social support, and treatment experience were also examined, although the evidence was less extensive. Evidence for altered pain modulation and metabolic or neuroendocrine factors was limited or inconsistent. Conclusion Mental health problems may affect a subset of adolescents with AIS and may not be fully reflected by curve severity alone. Biological, psychological, and social factors may all be relevant, although their relative contributions remain unclear. A biopsychosocial framework may help organize the available evidence and support a more comprehensive assessment of adolescents with AIS. Clinical trial registration Not applicable.