Factors associated with new-onset of mental health disorders in Bell's palsy patients: A MarketScan database study

Abstract

Objective: Limited research exists on mental health disorders (MHDs) in Bell's palsy patients. This study investigates risk factors associated with the development of MHDs in these patients.

Methods: MarketScan commercial and Medicare outpatient and prescription drug claims data were utilized to conduct this study on adults with Bell's palsy. Patients were identified using International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification diagnosis codes from 2014 to 2020 data. A one-year washout period was applied where patients did not have any diagnosis of MHD before Bell's palsy diagnosis. Patients were included if they were continuously enrolled for at least two years. The primary outcome was new-onset of any MHDs within one year of diagnosis of Bell's palsy. Descriptive statistics and logistic regression model explored risk factors associated with the development of any MHDs.

Results: Out of 37,166 Bell's palsy patients (mean age 49; 50.4 % female), 8.27 % experienced new-onset MHDs, with anxiety being the most prevalent (3.88 %). Female sex [Adjusted odds ratio (AOR) 1.40, 95 % CI 1.30-1.51, p < 0.0001], increasing Charlson comorbidity index (AOR 1.11, 95 % CI 1.04-1.176, p = 0.001), and symptoms like headache (AOR 1.16, 95 % CI 1.34-1.81, p < 0.0001) and facial pain (AOR 1.71, 95 % CI 1.15-2.52, p = 0.007) were associated with increased odds of new-onset of MHDs.

Conclusion: Bell's palsy patients can develop MHDs within first year of diagnosis, although the incidence of MHDs in this cohort is lower than that of the general population. Several factors are associated with the development of MHDs. These findings underscore the significance of addressing mental health in Bell's palsy patients, offering valuable considerations for clinical care and future research.

Keywords: Bell's palsy; Facial paralysis; Mental health disorders.