Psychiatric Morbidity Following Adult Scoliosis: A 10-year Nationwide Cohort Study in South Korea

Background This study investigated the long-term risk of major psychiatric disorders—depressive disorder, anxiety disorder, somatoform disorder, and sleep disorder—among adults with scoliosis using a nationwide population-based cohort in South Korea. Methods We used data from the Korean National Health Insurance Service National Sample Cohort (2002-2013). Adults newly diagnosed with scoliosis (ICD-10 code M41) were matched 1:10 to controls using propensity scores based on demographic and clinical variables. Individuals with prior psychiatric diagnoses or major neurological/systemic comorbidities were excluded. Adjusted hazard ratios (aHRs) were estimated using Cox proportional hazards models controlling for age, sex, lifestyle, metabolic, and socioeconomic factors. Results Among 2511 scoliosis patients, scoliosis was significantly associated with higher risks of depressive disorder (aHR 1.53), anxiety disorder (1.23), somatoform disorder (1.54), and sleep disorder (1.54) over 10 years. Risks were notably elevated in younger adults and males. Kaplan–Meier curves showed higher cumulative incidence of all psychiatric outcomes in the scoliosis group. Conclusions Adults with scoliosis face a significantly increased long-term risk of psychiatric disorders. These findings highlight the need for integrated mental health strategies in scoliosis care, particularly for working-age patients.