Body Image and Body Schema in Adolescents with Idiopathic Scoliosis: A Scoping Review

Abstract

Alterations in body representations (i.e., body image and body schema) are increasingly getting attention in clinical practice. Adolescents affected by idiopathic scoliosis experience body image dissatisfaction, and alterations in body schema have been suggested to be a consequence of the disease development. Although research has recognized the predisposing role of body representation disorders to psychopathologies, these aspects have been largely overlooked in this clinical population. This scoping review aims to establish the state of the art on the widely neglected aspects of body image and body schema disorders in adolescents affected by idiopathic scoliosis. PubMed, Scopus, PsycInfo, and MEDLINE were consulted to select articles published between 2000 and 2021. Three independent reviewers identified 27 articles by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review guidelines. Body image was assessed in 24 of the 27 studies. Body image disorders were reported, with more severe scoliosis cases showing higher body image dissatisfaction. Surgery seems to be the best approach to improve body image outcomes, but studies did not reveal clear associations between clinical measures of scoliosis severity (e.g., Cobb angle, hump height) and body image. Disorders of body schema have been reported, but the finding might have been biased by the paucity of studies on this aspect of body representations (4/27). This review highlighted the wide prevalence of psychological distress and body schema alterations among adolescents affected by idiopathic scoliosis; but it also revealed that both are disregarded and not properly evaluated.