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Research Article | DOI: https://doi.org/10.31579/2690-1919/518
1Department of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, College of Health Sciences. University of Port Harcourt, Port Harcourt. Rivers State. Nigeria.
2Department of Child Dental Health, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos State, Nigeria.
*Corresponding Author: Sylvia Simon Etim., Department of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, College of Health Sciences. University of Port Harcourt, Port Harcourt. Rivers State. Nigeria.
Citation: Sylvia S. Etim, Onyinye D. Umeh, (2025), Psychosocial Impact of Malocclusion: Findings from A Tertiary Hospital in South-South Nigeria, J Clinical Research and Reports, 19(3); DOI:10.31579/2690-1919/518
Copyright: © 2025, Sylvia Simon Etim. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 14 March 2025 | Accepted: 25 March 2025 | Published: 07 April 2025
Keywords: malocclusion; psychosocial impact; self-confidence; aesthetic concern
Background: Malocclusion can cause a lack of confidence and a resultant psychosocial effect on an individual. This study aimed to assess the psychosocial effect of malocclusion on orthodontic patients.
Procedures: A cross-sectional study based on a validated semi-structured questionnaire - Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ) was conducted. The questionnaire elicited information on socio-demographic data (Section A), the psychosocial impact of malocclusion before treatment (Section B), and during treatment (Section C). Data was imputed and uploaded for analysis using IBM SPSS version 26. Descriptive and inferential statistics were done and the level of significance was set at P ≤ 0.05.
Findings: One hundred and thirty-five (135) patients were involved in this study including females (78, 57.8%), and males (57, 42.2%) with a mean age of 19.32±7.008 years. Most were in the 10-19 years age group, followed by the 20-29 years participants. The 30-39 years group had the highest PIDAQ score signifying a higher psychosocial impact of malocclusion, while the 40-49 years group participants had the lowest. Mean PIDAQ scores for all subscales before treatment in males and females showed statistically significant differences between the two genders except for Self-confidence which had a P-value of 0.292. Participants of tertiary level had greater psychological, social impact and more aesthetic concerns of malocclusion yet better self-confidence.
Conclusion: The psychosocial impact of malocclusion was remarkable across genders and different age groups though significantly more in the 30-39-year-olds, and females. Educational level appears to significantly influence the individuals.
Malocclusion can be considered as a physical disability as it restricts a person’s social relationships, and hence their opportunities (Dalaie et al, 2018). Individuals desire to have a sense of belonging and to be socially accepted. When there is a lack or deficiency in this expectation, a person becomes unsatisfied with his/ her self-appearance with a resultant lack of confidence, which is a psychosocial burden (Seehra et al, 2011). This dissatisfaction with their self-appearance makes some individuals seek orthodontic treatment to get their malocclusion treated. Studies (De Oliveira &Sheiham, 2004; Bellot-Arcis et al, 2015; Bellot-Arcis et al, 2013; Twigge et al, 2016 & Grewal et al, 2019) have shown that malocclusion is associated with a psychosocial impact on individuals especially as the condition worsens and it’s been revealed that correcting the malocclusion improves the individuals' psychosocial, social impacts, and aesthetic concerns. Many have been seen to feel happier during treatment, from the positive changes they see in their dentition. Over time, it’s become necessary to have an objective tool to measure the psychosocial effect of malocclusion on patients. The commonly used tool for this is the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) (Klages et al, 2006), which has proven to be valid and reliable in adolescents and young adult orthodontic patients. This questionnaire, originally applied in German among people aged 18 to 30 years, has long been translated into English and used around the globe across different age boundaries. It objectively measures the quality of life linked to dental aesthetics.
Although studies (Kanmodi et al, 2020; Onyeaso & Sanu, 2005; Onyeaso et al, 2005 & Akpasa et al, 2022) have investigated the psychological impact of malocclusion among adolescents in North and South-West Nigeria, an extensive literature search found a dearth of information reporting the situation among orthodontic patients in South-South Nigeria. Orthodontic treatment has been carried out over ten years in a tertiary hospital in Port Harcourt, South-South region of Nigeria. This study was conceived to assess the psychosocial impact of malocclusion among orthodontic patients in University of Port Harcourt Teaching Hospital (UPTH), a tertiary healthcare center and a major hub for orthodontic services in South-South Nigeria.
This was a cross-sectional study carried out over an 8-months period among orthodontic patients at the Department of Child Dental Health, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Informed consent was obtained from participants willing to complete the study questionnaire among patients undergoing treatment at the time. Data was collected using a semi-structured, self-administered questionnaire - PIDAQ. The questionnaire had three sections. Section A elicited socio-demographic data, while Sections B and C respectively elicited information on the Psychosocial impact of malocclusion before treatment and during treatment based on four subscales: Social Impact, Aesthetic Concern, Dental Self- confidence and Psychological Impact, each rated on a five-point Likert scale. Information obtained was imputed and analyzed using IBM SPSS version 26. Frequency distribution tables were generated for categorical variables and inferential statistics were done with t-test and Chi-square test. The test of significance was set at a P- value ≤ 0.05. The study was approved by the Ethics and Research Committee (ERC) of the University of Port Harcourt Teaching Hospital (UPTH/ADM/90/S.11/VOL.XI/1837).
The data was systematically analyzed to describe the socio-demographic patterns of participants and findings in different subscales of the PIDAQ. Furthermore, inferential tests were performed to determine the influence of factors such as age, gender, and educational level of patient on the psychosocial impact of malocclusion.
Patients’ Socio-demographics
The study involved one hundred and thirty-five (135) patients of which 78 (57.8Percentage) were females and 57 (42.2Percentage) were males with a mean age of 19.32 ± 7.008 years. Most of the patients, 74 (54.8Percentage) were of tertiary educational level. In terms of the occupational identity of patients, there were 50 (37.6Percentage) students, 24(17.8Percentage) civil servants, 7(5.2Percentage) Business tycoons, and 5(3.7Percentage) Content writers. Most of the patients were ages 10-19 years (87, 64.4Percentage), followed by 20-29 (37, 27.4Percentage), 30-39 years (8, 5.9Percentage), and 40-49 years (3, 2.2Percentage). Most, 120(88.9Percentage) were single, while only 14(10.4Percentage) were married.
Parents’ Socio-demographics
Parental occupation showed similar pattern for Fathers and mothers: Civil servants - Fathers, 93(68.9Percentage); Mothers, 88 (65.2Percentage); Business tycoons - Fathers, 33(24.4Percentage); Mothers, 42(31.1Percentage); Retirees - Fathers, 7 (5.2Percentage); Mothers, 5 (3.7Percentage). Similarly, parents' levels of education were symmetrical for fathers and mothers: Tertiary - fathers, 119(88.1Percentage); mothers, 117 (86.7Percentage); Secondary - fathers, 14 (10.4Percentage), mothers, 18 (13.3Percentage).
PIDAQ subscales (Table 1)
1. Dental Self-Confidence: the mean value before treatment was 8.21 + SD 6.62 which increased after treatment to 18.67+ SD 6.57. (Table 1)
2. Social Impact: the mean Likert score before treatment was 13.46, with SD 8.64, and decreased to 9.14 ± SD 7.44 after treatment. (Table 1). There was a statistically significant difference between before treatment and after, with a P-value of 0.001.
3. Psychological Impact: Before treatment, the mean value was 12.62 with SD 7.52 while during treatment, the mean decreased to 6.03 with SD 5.43 showing a reduction in psychological distress. The P-value was 0.0001 showing a statistically significant difference between before and after treatment. (Table 1)
4. Aesthetic Concern: Before treatment, the mean Likert score was 7.82 ± 4.91, and reduced during treatment to a mean Likert value of 4.22 ± 4.33, showing a reduction in the patients’ aesthetic concerns during treatment (Table 1).
Then Overall, the mean PIDAQ Score before treatment was 42.05 ± 16.58, and during treatment, 38.07 ± 15.11, showing a reduced psychosocial impact during treatment.
| Before treatment | During treatment | |||||
| Mean | SD | Mean | SD | t-test | p-value | |
| Self-confidence total score | 8.21 | 6.62 | 18.67 | 6.57 | -15.179 | 0.0001 |
| Social impact total score | 13.46 | 8.64 | 9.14 | 7.44 | 4.998 | 0.0001 |
| Psychological impact total score | 12.62 | 7.52 | 6.03 | 5.43 | 9.807 | 0.0001 |
| Aesthetic concern total score | 7.82 | 4.91 | 4.22 | 4.43 | 7.098 | 0.0001 |
| PIDAQ SCORE | 42.05 | 16.58 | 38.07 | 15.11 | 2.722 | 0.007 |
Table 1: Psychological impact of malocclusion among treated orthodontic patients.
Age group and Psychosocial impact of malocclusion:
Dental self-confidence: Before treatment, The 20-29-years-old age group had a mean Likert score of 7.54 being the least and the 40-49-years-old age group with a mean of 12.00 being the highest but no statistically significant difference across the age groups shown with P-value 0.696. (Table 2) During treatment; the 20-29 years age group showed the lowest mean Likert score of 16.65 and the highest by 30 39 years age group with 22.00 but there was no statistically significant difference in the mean Likert scores seen across age groups shown with P-value, 0.100 (Table 2)
Social Impact: Before treatment; the 20-29 years age group showed the highest mean Likert score of 15.32 and least by the 40-49- years old age group with 5.33 but there was no statistically significant difference in the mean PIDAQ scores across the age group, (P- value 0.166). (Table 2) During treatment; the 20-29 years age group showed the highest Likert score of 12.62 and least seen among the 30-39 years age group with 6.13 and there was a statistically significant difference in the mean scores across the age groups as shown with P-value 0.007. (Table 2)
Psychological Impact: The 30-39 years age group had the highest mean Likert score of 16.00, and the 40-49 years age group had the lowest with 9.00 before treatment. The P-value was 0.098 which showed no statistical significant difference among the age groups. (Table 2) During treatment, the 40-49 years age group had a mean Likert score of 12.00 while the 30-39 had a mean score of 3.63, and there was a statistically significant difference in the mean Likert scores across the age groups as seen with P-value 0.003. (Table 2)
Aesthetic concern; before treatment, the 20-29 years age group was found to have a mean Likert score of 8.54, and the least found among the 40-49 years age group with 5.00. The P-value was 0.551, with no statistically significant difference across the age groups. During treatment, the 40-49 years age group was found to have a mean Likert score of 8.00 and the 30-39 years age group had 3.88, the P-value was 0.35 showing there was no statistical significant difference across the age groups. (Table 2) Overall, the highest PIDAQ score, 48.13 was found among the 30-39 years age group before treatment while during treatment, the highest PIDAQ score, 47.33 was found in the 40-49 years age group. (Table 2)
| Age group | p-value | ||||||||
| 10-19 | 20-29 | 30-39 | 40-49 | ||||||
| Mean | SD | Mean | SD | Mean | SD | Mean | SD | ||
| Before treatment | |||||||||
| Self-confidence total score | 8.30 | 6.49 | 7.54 | 6.88 | 8.88 | 5.64 | 12.00 | 11.36 | 0.696 |
| Social impact total score | 12.82 | 8.59 | 15.32 | 8.64 | 14.88 | 8.63 | 5.33 | 5.51 | 0.166 |
| Psychological impact total score | 11.62 | 7.39 | 14.54 | 7.14 | 16.00 | 6.55 | 9.00 | 13.89 | 0.098 |
| Aesthetic concern total score | 7.56 | 5.08 | 8.54 | 4.41 | 8.38 | 4.50 | 5.00 | 7.81 | 0.551 |
| PIDAQ SCORE | 40.21 | 15.98 | 45.95 | 17.04 | 48.13 | 16.26 | 31.33 | 23.16 | 0.141 |
| During treatment | |||||||||
| Self-confidence total score | 19.24 | 6.62 | 16.65 | 6.20 | 22.00 | 5.35 | 18.33 | 9.07 | 0.100 |
| Social impact total score | 7.94 | 6.16 | 12.62 | 9.23 | 6.13 | 6.77 | 9.00 | 7.94 | 0.007 |
| Psychological impact total score | 5.14 | 4.82 | 8.16 | 5.69 | 3.63 | 4.10 | 12.00 | 12.00 | 0.003 |
| Aesthetic concern total score | 3.90 | 4.25 | 4.76 | 4.55 | 3.88 | 4.42 | 8.00 | 8.00 | 0.359 |
| PIDAQ SCORE | 36.22 | 13.83 | 42.19 | 17.57 | 35.63 | 11.61 | 47.33 | 20.60 | 0.145 |
Table 2: Age groups and Psychosocial impact of malocclusion.
| GENDER | t-test | p-value | ||||
| Male | Female | |||||
| Mean | SD | Mean | SD | |||
| Before treatment | ||||||
| Self-confidence total score | 8.96 | 7.07 | 7.65 | 6.25 | 1.059 | 0.292 |
| Social impact total score | 11.51 | 7.28 | 14.88 | 9.29 | -2.339 | 0.021 |
| Psychological impact total score | 10.28 | 6.14 | 14.33 | 7.99 | -3.299 | 0.001 |
| Aesthetic concern total score | 6.43 | 4.52 | 8.82 | 4.97 | -2.853 | 0.005 |
| PIDAQ SCORE | 37.07 | 15.37 | 45.69 | 16.57 | -3.026 | 0.003 |
| During treatment | ||||||
| Self-confidence total score | 18.32 | 7.05 | 18.94 | 6.23 | -0.395 | 0.694 |
| Social impact total score | 9.789 | 8.419 | 8.667 | 6.658 | 0.861 | 0.391 |
| Psychological impact total score | 5.84 | 5.52 | 6.17 | 5.40 | -0.342 | 0.733 |
| Aesthetic concern total score | 3.82 | 4.07 | 4.51 | 4.68 | -0.842 | 0.401 |
| PIDAQ SCORE | 37.77 | 16.33 | 38.28 | 14.26 | -0.099 | 0.921 |
Table 3: Gender and Psychosocial impact of malocclusion.
| LEVEL OF EDUCATION | t-test | p-value | ||||
| Secondary | Tertiary | |||||
| Mean | SD | Mean | SD | |||
| Before treatment | ||||||
| Self-confidence total score | 8.30 | 6.37 | 8.14 | 6.86 | .085 | .932 |
| Social impact total score | 12.28 | 7.96 | 14.43 | 9.10 | -1.422 | .157 |
| Psychological impact total score | 11.28 | 7.51 | 13.73 | 7.39 | -1.872 | .063 |
| Aesthetic concern total score | 7.05 | 5.08 | 8.45 | 4.72 | -1.646 | .102 |
| PIDAQ SCORE | 38.79 | 15.16 | 44.74 | 17.30 | -2.054 | .042 |
| During treatment | ||||||
| Self-confidence total score | 19.30 | 7.02 | 18.16 | 6.17 | 1.150 | .252 |
| Social impact total score | 6.967 | 5.199 | 10.932 | 8.502 | -3.158 | .002 |
| Psychological impact total score | 4.54 | 4.30 | 7.26 | 5.97 | -2.976 | .003 |
| Aesthetic concern total score | 3.57 | 3.98 | 4.76 | 4.73 | -1.506 | .134 |
| PIDAQ SCORE | 34.38 | 12.18 | 41.11 | 16.62 | -2.548 | .012 |
Table 4: Educational level of participants and Psychosocial impact of malocclusion.
Gender and Psychosocial impact of malocclusion
Self-Confidence: Before treatment, the males had a mean Likert score of 8.96 while females had 7.65, with P-value, 0.292 showing no statistically significant difference. During treatment, males had a mean Likert score of 18.32, while females had 18.94 with a P-vale of 0.694 showing no statistically significant difference.
Social Impact: Before treatment, the males had a mean Likert score of 11.51 and the females had 14.88, P-value 0.021 showing a statistical significant difference between genders. During treatment, the males had a mean Likert score of 9.789 and the females had 8.667, P-value of 0.391 showing no statistically significant difference between genders.
Psychological impact: Before treatment, a mean Likert score of 10.28 was found among the male participants and 14.33 for the females with a P-value of 0.001 showing a statistically significant difference between the two genders. During treatment, the male participants were found to have a mean Likert score of 5.84 and the female participants, 6.11 with a P-value of 0.733 showing a non-statistical significant difference between the genders.
Aesthetic concern: Before treatment, male participants had a mean Likert score of 6.43 while the females had 8.82 with a P-value of 0.005 showing a statistically significant difference. During treatment, the males had a mean Likert score of 3.82 and females, 4.51 with a P-value of 0.401 showing a non-statistical significant difference.
Overall PIDAQ score before treatment for males was 37.07 and females 45.69 with a P-value of 0.003 showing a statistically significant difference between the two genders. During treatment; the overall PIDAQ score was 37.77 for males and 38.28 for females with a P-value of 0.921 showing insignificant statistical difference.
Educational level and Psychosocial impact of malocclusion
Self-confidence: The mean Likert score for secondary school participants was 8.30 while tertiary was 8.14 before treatment with a P-value, of 0.932 showing no statistically significant difference between the two educational levels. During treatment, the mean Likert score for the secondary school participants was 19.30 while the tertiary was 18.16, P-value was 0.252 showing an insignificant statistical difference between the two.
Social Impact: Secondary school participants had a mean Likert score of 12.28 and tertiary had 14.43 before treatment. There was no statistical significant difference between the two as the P-value was found to be 0.157. During treatment, the mean scores were 6.967 for the secondary participants and 10.932 for the tertiary participants with a P-value of 0.002 which showed a statistically significant difference between the two educational levels.
Psychological impact: The mean Likert score for secondary school participants was 11.28 while for tertiary participants, it was 13.73 before treatment. The P-value was 0.063 while during treatment, the mean scores were 4.54 and 7.26 for secondary school and tertiary participants, respectively with a P-value of 0.003, tertiary participants had the higher psychological impact of malocclusion than secondary-level participants.
Aesthetic Concerns: Before treatment, the mean Likert score for secondary and tertiary participants was 7.05 and 8.45, respectively. During treatment, the mean scores were 3.57 and 4.76, respectively which showed that the tertiary participants had more aesthetic concerns about their malocclusion.
Overall PIDAQ score before treatment for secondary is 38.79 and 44.74 for tertiary participants with a P-value of 0.042 showing a statistically significant difference between patients of the two educational levels. During treatment, secondary participants had a PIDAQ score of 34.38 and 41.11 for tertiary participants with a P-value of 0.012 which means there was a statistically significant difference between the two.
Malocclusion can have various negative effects on the well-being of individuals. These effects could vary depending on the age groups, gender, and educational levels of the individuals involved. In this survey, more females than males were found to seek orthodontic treatment, which could mean they are more concerned about their appearance. This is consistent with reports from previous studies (Motloba et al, 2016; Badran & Khateeb, 2013 & Harris & Gassell, 2011) where twice as many females than males sought orthodontic treatment. The mean PIDAQ score before orthodontic treatment in this study was found to be 42.05, which is comparable to that seen in a previous study (Motloba et al, 2016) showing a significant psychosocial impact of malocclusion on orthodontic patients. The PIDAQ finding here however is different from that of a previous study (Gassen et al, 2022) with PIDAQ 37.02. The difference seen in this study could be that this survey had patients of various age groups not just young adults as seen in the previous survey. In our study, we found that most patients treated were single, similar to what was seen in a study by Gassen et al, 2022. This pattern could be because individuals not married tend to be more particular about their dental appearance as this can affect their social interaction and connectiveness. The 30-39 years age group had a total PIDAQ score of 48.13 which was the highest among the studied groups showing this group had the highest negative psychosocial impact and the lowest PIDAQ score was found among the 40-49 years age group before treatment. This could be because this age group has lived longer than other age groups and has accepted whatever malocclusion they have, not letting it affect their psychosocial well-being. This report was similar to previous ones (Akpasa et al, 2022; Motloba et al, 2016; Badran & Khateeb, 2013 & Wahab et al, 2021) where age was found not to have a significant association with the psychosocial impact of malocclusion. During treatment, the PIDAQ score for all age groups reduced except for the 40-49 years age group. This report could be due to the bracket material (stainless steel) used for the orthodontic treatment of these patients which might not be aesthetically pleasing for this age group (older) compared to the younger age groups and also the treatment progress may not have been as fast as they had envisaged. The finding in this survey that age was not found to have a significant association with the psychosocial impact of malocclusion contrasted with a previous report (Illijazi et al, 2021) as age was found to play a role in the psychosocial impact of malocclusion. Female participants in this current study had a higher total PIDAQ score of 45.69 as compared to males, 37.07 and there was a statistically significant difference between genders. This finding showed females had a greater psychosocial impact of malocclusion than males. This report was similar to findings from previous studies, (Twigge et al, 2016; Wahab et al, 2021; Nazir et al, 2014; Venete et al, 2017; Christopherson et al, 2009 & Dzemidzic et al, 2023). For the subscales, the males displayed higher DSC mean scores in comparison to the females though the differences were not statistically significant in this survey. This contravenes a previous report (Motloba et al, 2016) where male studied participants had lower self-esteem compared to females however similar to reports of previous studies (Harris & Gassell, 2011 & Jawad et al, 2015). The educational level of participants also had a role to play in the psychosocial impacts of malocclusion as patients at the tertiary level were found to have a higher PIDAQ score than the secondary-level ones. This means that they had negative psychosocial impact of malocclusion and the difference was statistically significant. Contrarily, a previous Nigerian study (Akpasa et al, 2022) showed that academic level had no significant association with the psychosocial impact of malocclusion.
Age, gender, and educational level of orthodontic patients were found to have a relationship with the psychosocial impact of malocclusion, however, gender and educational level had a significant relationship. There was a reduced psychosocial impact of malocclusion on patients during treatment than before treatment. It is therefore important to encourage orthodontic treatment for patients with malocclusions.
Limitation of the Study: The psychosocial impact of malocclusion during treatment was not assessed at a specific month for all patients after the commencement of orthodontic treatment to have all the patients at a similar level of assessment.
1 Evaluation and treatment for malocclusion should be considered in the overall management of individuals with psychosocial disorders.
2 Subsidizing the treatment of malocclusion would enhance the psychological health of affected patients who are unable to afford orthodontic treatments. We therefore recommend a subsidy policy by the government.
The research was sponsored by the authors.
The authors declare there was no conflict of interest in carrying out this research.
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We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
