Psychiatric comorbidities have been well documented in patients with neurofibromatosis 1 (NF1),1-3 and none of these psychological or psychiatric conditions are correlated with the severity of somatic symptoms.2,3 We recently published in the ARCHIVES that NF1 has a significant impact on quality of life through alteration of health and appearance.4 While conducting this quality-of-life study, we evaluated the impact of NF1 visibility and severity on psychiatric morbidity.