Abstract
This paper discussesp sychiatric p roblems surrounding nine adolescentsw ith repaired cleft lip and palate who manifested any noncompliance during orthodontic treatment for mandibular protrusion. The results were as follows:
1. Some patients encountered ps y chologicald ifficultiesd ue to staring, ridicule, whispering, and teasing by other persons in relation to their facial impairment during orthodontic treatment. They were also more likely to deepen social introversion related to defective speech.
2. Reasonsf or noncompliancew ere:
1) followedb y adjustmentd isorders w ith nonattendancea t school and violence in the family.
2) those who manifesteds elf-diagnosticm anner associatedw ith dysmorphophobia.
3) depression.
4) those complainants who did not follow through with orthodontic recommendations.
Ambivalence of aggression and dependency was observed especially in cases 1),2), and 4).
3. Despite the simultaneous stresses, due to facial impairment, defective speech, family crisis, and hard schedules of school life, a few adolescents avoided psychological risks and could discover thei r own identity by placing priority on sports or hobbies, which played the role of sublimate action in defeating opponents.
4. Intro duction of consultation-liaison psychiatry to cleft lip and palate patients was emphasized to promote multidisciplinary attention to cleft lip and palate patients among operators, families and medical staffs.
