Features of the palsy affecting distress:
(1) longer duration
(2) perception of the underlying illness and its consequences
The severity of the palsy did not correlate with the level of distress experienced.
Emotional factors that may increase distress:
(1) anxiety, which was greater in females
(2) depression
(3) maladaptive behaviors
Embarrassment:
(1) because of perceiving self as disfigured
(2) when eating
(3) when talking
Frustration
(1) with being unable to express emotions
(2) with being unable to communicate effectively with others
(3) with being misinterpreted by others
All patients with facial nerve palsy should be screened for distress.