口腔黏膜常见疾病与心理因素的关系
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摘要
目的探讨心理因素与复发性阿弗他溃疡(recurrent aphthous ulcer, RAU)、口腔扁平苔藓(oral lichen planus, OLP)、灼口综合征(burning mouth syndrome, BMS)的联系,为疾病的临床诊治提供参考。方法选择2018年7—10月在南京大学医学院附属口腔医院口腔黏膜病科门诊就诊的普通性RAU、顽固性RAU、OLP、BMS患者各50例作为观察组,同时选择50名无重大系统性疾病和口腔黏膜疾病且年龄、性别等与试验组相匹配的健康人作为对照组。对各组研究对象分别进行问卷调查分析心理状态,包括广泛性焦虑障碍量表(the generalized anxiety disorder 7?item scale,GAD?7)及9项患者健康问卷表(patient health questionnare?9, PHQ?9)。结果顽固性RAU、普通性RAU、OLP、BMS与对照组相比,PHQ?9的得分均高于对照组,差异有统计学意义(P <0.05);顽固性RAU、OLP、BMS与对照组相比,GAD?7的得分高于对照组,差异有统计学意义(P <0.05)。RAU组中,顽固性RAU的GAD?7得分高于普通性RAU,差异有统计学意义(P <0.05),但PHQ?9得分差异无统计学意义(P>0.05)。结论 RAU、OLP、BMS作为口腔黏膜病科常见的心身疾病,其发生、发展与患者的心理状态有关系,顽固性RAU患者的焦虑倾向比普通性RAU患者显著。
Objective To explore the relationship between psychological factors and recurrent aphthous ulcer(RAU), oral lichen planus(OLP), and burning mouth syndrome(BMS) and to provide a reference for clinical diagnosis and treatment of the disease.MethodsFrom July to October 2018, 50 patients with common RAU, refractory RAU,OLP and BMS were selected as the observation group, and 50 healthy participants without major systemic diseases and oral mucosal diseases matched for age and sex served as the control group. The psychological status of the subjects in each group was investigated by questionnaires, including the generalized anxiety disorder 7?item scale(GAD?7) and the patient health questionnaire?9(PHQ?9).ResultsCompared with the control group, the PHQ?9 scores in the refractory RAU, common RAU, OLP and BMS groups were higher than those in the control group(P < 0.05), and the GAD?7 scores in the refractory RAU, OLP and BMS groups were higher than those in the control group(P < 0.05). In the RAU group, the GAD?7 score of intractable RAU was higher than that of common RAU(P < 0.05), and there was no signifi?cant difference in the PHQ?9 score(P > 0.05).ConclusionRAU, OLP and BMS are common psychosomatic diseases presented by patients in the Department of Oral Mucosal Diseases. Their occurrence and development are related to the psychological status of patients. A tendency toward anxiety is significantly more common among refractory RAU patients than common RAU patients.
Objective To explore the relationship between psychological factors and recurrent aphthous ulcer(RAU), oral lichen planus(OLP), and burning mouth syndrome(BMS) and to provide a reference for clinical diagnosis and treatment of the disease.MethodsFrom July to October 2018, 50 patients with common RAU, refractory RAU,OLP and BMS were selected as the observation group, and 50 healthy participants without major systemic diseases and oral mucosal diseases matched for age and sex served as the control group. The psychological status of the subjects in each group was investigated by questionnaires, including the generalized anxiety disorder 7?item scale(GAD?7) and the patient health questionnaire?9(PHQ?9).ResultsCompared with the control group, the PHQ?9 scores in the refractory RAU, common RAU, OLP and BMS groups were higher than those in the control group(P < 0.05), and the GAD?7 scores in the refractory RAU, OLP and BMS groups were higher than those in the control group(P < 0.05). In the RAU group, the GAD?7 score of intractable RAU was higher than that of common RAU(P < 0.05), and there was no signifi?cant difference in the PHQ?9 score(P > 0.05).ConclusionRAU, OLP and BMS are common psychosomatic diseases presented by patients in the Department of Oral Mucosal Diseases. Their occurrence and development are related to the psychological status of patients. A tendency toward anxiety is significantly more common among refractory RAU patients than common RAU patients.
引文
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[13] Adamo D, Cascone M, Celentano A, et al. Psychological profiles in patients with symptomatic reticular forms of oral lichen planus:A prospective cohort study[J]. J Oral Pathol Med, 2017, 46(9):810?816.
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[16] Alves MG, do CCBF, Balducci I, et al. Emotional assessment of patients with oral lichen planus[J]. Int J Dermatol, 2015, 54(1):29?32.
[17] Galli F, Lodi G, Sardella A, et al. Role of psychological factors in burning mouth syndrome:a systematic review and meta?analysis[J]. Cephalalgia, 2017, 37(3):265?277.
[18] Tokura T, Kimura H, Ito M, et al. Temperament and character pro?files of patients with burning mouth syndrome[J]. J Psychosom Res, 2015, 78(5):495?498.
[19] Conrad R, Wegener I, Geiser F, et al. Temperament, character,and personality disorders in chronic pain[J]. Curr Pain Headache Rep, 2013, 17(3):317?318.
[20] Yap AU, Chua AP. Sleep bruxism:current knowledge and contem?porary management[J]. J Conserv Dent, 2016, 19(5):383?389.
[2] Saikaly SK, Saikaly TS, Saikaly LE. Recurrent aphthous ulcer?ation:a review of potential causes and novel treatments[J]. J Der?matolog Treat, 2018, 29(6):542?552.
[3] Ivanovski K, Nakova M, Warburton G, et al. Psychological profile in oral lichen planus[J]. J Clin Periodontol,2005, 32(10):1034?1040.
[4] de Souza FT, Kummer A, Silva ML, et al. The association of open?ness personality trait with stress?related salivary biomarkers in burning mouth syndrome[J]. Neuroimmunomodulation,2015, 22(4):250?255.
[5] Lucchesi C, Baldacci F, Cafalli M, et al. Fatigue, sleep?wake pat?tern, depressive and anxiety symptoms and body?mass index:anal?ysis in a sample of episodic and chronic migraine patients[J].Neurol Sci,2016, 37(6):987?989.
[6] Kroenke K, Spitzer RL, Williams JB, et al. The patient health questionnaire somatic, anxiety, and depressive symptom scales:a systematic review[J]. Gen Hosp Psychiatry, 2010, 32(4):345?359.
[7] Mikocka?Walus A, Pittet V, Rossel JB, et al. Symptoms of depres?sion and anxiety are independently associated with clinical recur?rence of inflammatory bowel disease[J]. Clin Gastroenterol Hepa?tol, 2016, 14(6):829?835.
[8] Gavic L, Cigic L, Biocina LD, et al. The role of anxiety, depres?sion, and psychological stress on the clinical status of recurrent aphthous stomatitis and oral lichen planus[J]. J Oral Pathol Med,2014, 43(6):410?417.
[9] Al?Omiri MK, Karasneh J, Alhijawi MM, et al. Recurrent aph?thous stomatitis(RAS):a preliminary within?subject study of quali?ty of life, oral health impacts and personality profiles[J]. J Oral Pathol Med, 2015, 44(4):278?283.
[10] Ajmal M, Ibrahim L, Mohammed N, et al. Prevalence and psycho?logical stress in recurrent aphthous stomatitis among female den?tal students in Saudi Arabia[J]. Clujul Med, 2018, 91(2):216?221.
[11] Pekiner FN, Demirel GY, Borahan MO, et al. Cytokine profiles in serum of patients with oral lichen planus[J]. Cytokine, 2012, 60(3):701?706.
[12] Jaremka LM, Lindgren ME, Kiecolt?Glaser JK. Synergistic rela?tionships among stress, depression, and troubled relationships:in?sights from psychoneuroimmunology[J]. Depress Anxiety, 2013,30(4):288?296.
[13] Adamo D, Cascone M, Celentano A, et al. Psychological profiles in patients with symptomatic reticular forms of oral lichen planus:A prospective cohort study[J]. J Oral Pathol Med, 2017, 46(9):810?816.
[14] Radwan?Oczko M, Zwyrtek E, Owczarek JE, et al. Psychopatholog?ical profile and quality of life of patients with oral lichen planus[J]. J Appl Oral Sci, 2018, 26(7):01?06.
[15] Adamo D, Ruoppo E, Leuci S, et al. Sleep disturbances, anxiety and depression in patients with oral lichen planus:a case?control study[J]. J Eur Acad Dermatol Venereol, 2015, 29(2):291?297.
[16] Alves MG, do CCBF, Balducci I, et al. Emotional assessment of patients with oral lichen planus[J]. Int J Dermatol, 2015, 54(1):29?32.
[17] Galli F, Lodi G, Sardella A, et al. Role of psychological factors in burning mouth syndrome:a systematic review and meta?analysis[J]. Cephalalgia, 2017, 37(3):265?277.
[18] Tokura T, Kimura H, Ito M, et al. Temperament and character pro?files of patients with burning mouth syndrome[J]. J Psychosom Res, 2015, 78(5):495?498.
[19] Conrad R, Wegener I, Geiser F, et al. Temperament, character,and personality disorders in chronic pain[J]. Curr Pain Headache Rep, 2013, 17(3):317?318.
[20] Yap AU, Chua AP. Sleep bruxism:current knowledge and contem?porary management[J]. J Conserv Dent, 2016, 19(5):383?389.