The Comparison of Mood Factors in Individuals having Different Periodontal Status Using Depression Anxiety and Stress Scale-21 (DASS-21)

Yıl 2024, Cilt: 11 Sayı: 3, 262 - 268, 23.12.2024

Ali Batuhan Bayırlı , Mehmetcan Uytun

https://doi.org/10.15311/selcukdentj.1406539

Öz

Objectives: The purpose of this study was the evaluation and comparison of depression, anxiety, and stress levels in individuals who are periodontally healthy and who have gingivitis and periodontitis.

Material and Methods: This study involves 114 individuals in total, including 48 periodontally healthy patients, 48 patients who have gingivitis and 48 patients who have periodontitis. Clinical and radiological periodontal examinations of the individuals were conducted. Scores of gingival index (GI), plaque index (PI), pocket depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP) were recorded during intraoral examinations. Depression Anxiety and Stress Scale-21 (DASS-21) was used to determine levels of depression, anxiety, and stress.

Results: Depression, anxiety, and stress levels were meaningfully and statistically lowest in individuals who are periodontally healthy (p<0.001). Levels of clinical periodontal parameters in individuals who have periodontitis and gingivitis (PI, GI, BOP, PD, CAL) were seen to be meaningfully and statistically higher in comparison with individuals who are periodontally healthy (p<0.001). A positive correlation was observed among depression, anxiety and stress levels and clinical periodontal parameters (p<0.001).

Conclusions: Higher depression, anxiety and stress levels were seen in individuals with periodontitis. These mood factors may be some of the important situations that should be taken into consideration in the prevention and treatment of periodontal disease.

Keywords: Anxiety, depression, periodontal diseases, psychological stress

Anahtar Kelimeler

Anxiety, depression, periodontal diseases, psychological stress

Farklı Periodontal Duruma Sahip Bireylerdeki Duygudurum Faktörlerinin Depresyon Anksiyete Stres Ölçeği-21 (DASÖ-21) Kullanılarak Karşılaştırılması

Öz

Amaç: Bu çalışmanın amacı; periodontal sağlık, gingivitis ve periodontitis görülen bireylerdeki depresyon, anksiyete ve stres seviyelerinin değerlendirilip karşılaştırılmasıdır.

Gereç ve Yöntemler: Bu çalışmaya 48 periodontal sağlıklı, 48 gingivitisli ve 48 periodontitisli olmak üzere toplam 144 birey dahil edildi. Bireylerin klinik ve radyolojik periodontal muayeneleri yapıldı. Ağız içi muayeneler yapılırken gingival indeks (Gİ), plak indeksi (Pİ), sondalanabilir cep derinliği (SCD), klinik ataçman kaybı (KAK) ve sondalamada kanama (SK) skorları kaydedildi. Depresyon, anksiyete ve stres düzeylerinin belirlenmesi için Depresyon Anksiyete Stres Ölçeği-21 (DASÖ-21) kullanıldı.

Bulgular: Depresyon, anksiyete ve stres seviyeleri periodontal sağlıklı bireylerde istatistiksel olarak anlamlı şekilde en düşük olarak gözlendi (p<0.001). Periodontitis ve gingivitis bulunan bireylerde klinik periodontal parametrelerin (PI, GI, BOP, PD, CAL) seviyeleri periodontal sağlıklı bireylere göre istatistiksel olarak anlamlı şekilde daha yüksek olarak görüldü (p<0.001). Depresyon, anksiyete ve stres seviyeleri ile klinik periodontal parametreler arasında pozitif korelasyon gözlemlendi (p<0.001).

Sonuçlar: Periodontitisli bireylerde daha yüksek depresyon, anksiyete ve stres seviyeleri görüldü. Bu duygudurum faktörleri, periodontal hastalığın önlenmesi ve tedavisinde dikkate alınması gereken önemli durumlardan biri olabilir.

Anahtar Kelimeler: Anksiyete, depresyon, periodontal hastalıklar, psikolojik stres

Anahtar Kelimeler

Anksiyete, depresyon, periodontal hastalıklar, psikolojik stres

Kaynakça

• 1. Andras NL, Mohamed FF, Chu EY, Foster BL. Between a rock and a hard place: Regulation of mineralization in the periodontium. Genesis 2022;60(8-9): e23474.
• 2. American Academy of Periodontology and European Federation of Periodontology. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018;45: S68–77.3.
• 3. Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Periodontol 2018;89 Suppl 1: S46-S73.
• 4. Teles R, Benecha HK, Preisser JS, et al. Modelling changes in clinical attachment loss to classify periodontal disease progression. J Clin Periodontol.2016;43:426- 434.
• 5. American Academy of Periodontology and European Federation of Periodontology. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018;89 Suppl 1: S173-S182.
• 6. Lang NP, Bartold PM. Periodontal health. J Periodontol 2018;89 Suppl 1: S9-s16.
• 7. Cury PR, Araújo VC, Canavez F, Furuse C, Araújo NS. Hydrocortisone affects the expression of matrix metalloproteinases (mmp-1, -2, -3, -7, and -11) and tissue inhibitor of matrix metalloproteinases (timp-1) in human gingival fibroblasts. J Periodontol 2007; 78(7):1309-15.
• 8. da Silva AM, Newman HN, Oakley DA. Psychosocial factors in inflammatory periodontal diseases. J Clin Periodontol 1995; 22:516-526.
• 9. Lazarus, R. S. Psychological stress and the coping process. McGraw-Hill 1966.
• 10. Raymond, C. Stress the real millennium bug. Stress News 2000; 12(4).
• 11. Goyal S, Gupta G, Thomas B, Bhat K, Bhat G. Stress and periodontal disease: The link and logic!! Industrial psychiatry journal 2013; 22:4.
• 12. Rohleder N. Stress and inflammation- The need to address the gap in the transition between acute and chronic stress effects. Psychoneuroendocrinology 2019; 105:164-171.
• 13. Traylor CS, Johnson JD, Kimmel MC, Manuck TA. Effects of psychological stress on adverse pregnancy outcomes and nonpharmacologic approaches for reduction: an expert review. Am J Obstet Gynecol MFM 2020;2(4):100229.
• 14. Battle DE. Diagnostic and Statistical Manual of Mental Disorders (DSM). Codas 2013;25(2):191-2.
• 15. Gu R, Huang YX, Luo YJ. Anxiety and feedback negativity. Psychophysiology 2010; 47(5), 961-967.
• 16. Rozenman M, Piacentini J, O'Neill J, Bergman RL, Chang S, Peris TS. Improvement in anxiety and depression symptoms following cognitive behavior therapy for pediatric obsessive compulsive disorder. Psychiatry Res 2019; 276:115-123.
• 17. Pıçakçıefe M. Çalışma yaşamı ve anksiyete. TSK Koruyucu Hekimlik Bülteni 2010; 9(4): 367 - 374.
• 18. Johnson PR., Indvik J. The boomer blues: Depression in the workplace. Public Personnel Management 1997; 26(3), 359-365.
• 19. Kandola A, Ashdown-Franks G, Hendrikse J, Sabiston CM, Stubbs B. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev 2019; 107:525-539.
• 20. Budak S. Psikoloji Sözlüğü. Ankara: Bilim ve Sanat Yayınları, Ankara, 2000.
• 21. Yıldız M. Üniversite öğrencilerinde fonksiyonel olmayan tutumların ve olumsuz otomatik düşüncelerin depresyona etkisi. Ulusal Eğitim Akademisi Dergisi, 2017; 1(1): 1-7.
• 22. Beurel E, Toups M, Nemeroff CB. The Bidirectional Relationship of Depression and Inflammation: Double Trouble. Neuron 2020;107(2):234-256.
• 23. Heuser I, Deuschle M, Luppa P, Schweiger U, Standhardt H, Weber B. Increased diurnal plasma concentrations of dehydroepiand rosterone in depressed patients. J Clin Endocrinol Metab 1998;83(9):3130-3.
• 24. Tsigos C, Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res 2002;53(4): 865-71.
• 25. Freeman R, Goss S. Stress measures as predictors of periodontal disease--a preliminary communication. Community Dent Oral Epidemiol 1993;21(3):176-7.
• 26. Hsiao CC. Positive correlation between anxiety severity and plasma levels of dehydroepiandrosterone sulfate in medication free patients experiencing a major episode of depression. Psychiatry Clin Neurosci 2006;60(6):746-50.
• 27. Lach G, Schellekens H, Dinan TG, Cryan JF. Anxiety, Depression, and the Microbiome: A Role for Gut Peptides. Neurotherapeutics 2018;15(1):36-59.
• 28. Martínez M, Postolache TT, García-Bueno B, Leza JC, Figuero E, Lowry CA, et al. The Role of the Oral Microbiota Related to Periodontal Diseases in Anxiety, Mood and Trauma- and Stress-Related Disorders. Front Psychiatry 2022; 12:814177.
• 29. Warren KR, Postolache TT, Groer ME, Pinjari OK, Kelly DL, Reynolds MA. Role of chronic stress and depression in periodontal diseases. Periodontol 2000 2014; 64:127–13.
• 30. Haririan H, Andrukhov O, Böttcher M, Pablik E, Wimmer G, Moritz A, et al. Salivary neuropeptides, stress, and periodontitis. J Periodontol 2018; 89(1):9-18.
• 31. Kisely S, Sawyer E, Siskind D, Lalloo R. The oral health of people with anxiety and depressive disorders-a systematic review and meta-analysis. J Affect Disord 2016; 200:119-132.
• 32. Lovibond PF, Lovibond SH. Th e structure of negative emotional states: Comparison of the Depression Anxiety Stress Scale (DASS) with the Beck Depression and Anxiety Inventories. Behaviuor Research and Therapy 1995;33(3):335-43.
• 33. Özer Y, Boz H, Arslan A. "Depresyon anksiyete stres ölçeğinin (DASS 21) Türkçe kısa formunun geçerlilik-güvenilirlik çalışması." Finans Ekonomi ve Sosyal Araştırmalar Dergisi 2.2 2017; 78-91.
• 34. Sarıçam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. Journal of Cognitive-Behavioral Psychotherapy and Research 2018; 7(1), 19-30.
• 35. Sudhakara P, Gupta A, Bhardwaj A, Wilson A. Oral Dysbiotic Communities and Their Implications in Systemic Diseases. Dent J 2018;6(2):10.
• 36. Ball J, Darby I. Mental health and periodontal and peri-implant diseases. Periodontol 2000 2022;90(1):106-124.
• 37. Zheng DX, Kang XN, Wang YX, Huang YN, Pang CF, Chen YX, et al. Periodontal disease and emotional disorders: A meta-analysis. J Clin Periodontol 2021;48(2):180-204.
• 38. Okoro CA, Strine TW, Eke PI, Dhingra SS, Balluz LS. The association between depression and anxiety and use of oral health services and tooth loss. Community Dentistry and Oral Epidemiology 2012; 40, 134–144.
• 39. Leresche L, Dworkin SF. The role of stress in inflammatorydisease, including periodontal disease: review of conceptsand current findings. Periodontol 2000. 2002;30:91–103.
• 40. Dhabhar FS. Effects of stress on immune function: the good, the bad, and the beautiful. Immunol Res 2014;58(2-3):193-210.
• 41. Köhler CA, Freitas TH, Maes M, de Andrade NQ, Liu CS, Fernandes BS, et al. Peripheral cytokine and chemokine alterations in depression: a meta-analysis of 82 studies. Acta Psychiatr Scand 2017;135(5):373-387.
• 42. Belvederi Murri M, Pariante C, Mondelli V, Masotti M, Atti AR, Mellacqua Z, et al. HPA axis and aging in depression: systematic review and meta-analysis. Psychoneuroendocrinology 2014; 41:46-62.
• 43. Miller AH, Raison CL. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nat Rev Immunol 2016;16(1):22- 34.
• 44. Decker A, Askar H, Tattan M, Taichman R, Wang HL. The assessment of stress, depression, and inflammation as a collective risk factor for periodontal diseases: a systematic review. Clinical Oral Investigations 2019;24, 1–12.
• 45. Reshma AP, Arunachalam R, Pillai JK, Kurra SB, Varkey VK, Prince MJ. Chromogranin A: novel biomarker between periodontal disease and psychosocial stress. J Indian Soc Periodontol 2013;17(2):214–218.
• 46. Ishisaka A, Ansai T, Soh I, Inenaga K, Yoshida A, Shigeyama C, et al. Association of salivary levels of cortisol and dehydroepiandroster one with periodontitis in older Japanese adults. J Periodontol 2007;78(9): 1767–1773.
• 47. Meyer IH. Prejudice as stress: conceptual and measurement problems. Am J Public Health 2003;93:262–265.
• 48. Zimmerman M, Kerr S. How should the severity of depression be rated on self-report depression scales? Psychiatry Res. 2019;280:112512.
• 49. Blascovich J, Seery MD, Mugridge CA, Norris RK, Weisbuch M. Predicting athletic performance from cardiovascular indexes of challenge and threat. J Exp Soc Psychol 2004;40:683–688.
• 50. Mendes WB, Blascovich J, Lickel B, Hunter S. Challenge and Threat During Social Interactions With White and Black Men. Pers Soc Psychol Bull 2002;28:939–952.
• 51. Tatar A, Saltukoğlu G, Özmen E. "Madde Yanıt Kuramıyla Öz Bildirim Türü Stres Ölçeği Geliştirme Çalışması-I: Madde Seçimi, Faktör Yapısının Oluşturulması ve Psikometrik Özelliklerinin İncelenmesi". Nöropsikiyatri Arşivi 2018;55.2: 161-170.
• 52. Blascovich J, Mendes WB, Hunter SB, Lickel B, Kowai-Bell N. Perceiver threat in social interactions with stigmatized others. J Pers Soc Psychol 2001; 80:253–267.
• 53. Figueroa-Fankhanel F. Measurement of stress. Psychiatr Clin North Am 2014;37:455487.
• 54. Bale TL, Epperson CN. Sex differences and stress across the lifespan. Nat Neurosci 2015;18:1413–1420.
• 55. Bourne Jr, Lyle E, Rita A. Yaroush. Stress and cognition: A cognitive psychological perspective. No. IH-045 2003.
• 56. Kareem O, Ijaz B, Anjum S, Hadayat S, Tariq I, Younis M. Association of depression with dental caries and periodontal disease at a tertiary care hospital. J Pak Med Assoc. 2021;71(5):1345-1349.
• 57. Delgado-Angulo EK, Sabbah W, Suominen AL, Vehkalahti MM, Knuuttila M, Partonen T, et al. The association of depression and anxiety with dental caries and periodontal disease among Finnish adults. Community Dent Oral Epidemiol 2015;43(6):540-9.
• 58. Solis AC, Lotufo RF, Pannuti CM, Brunheiro EC, Marques AH, Lotufo-Neto F. Association of periodontal disease to anxiety and depression symptoms, and psychosocial stress factors. J Clin Periodontol 2004;31(8):633-638.
• 59. Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol 2013;62(1):59–94.
• 60. Kolte AP, Kolte RA, Lathiya VN. Association between anxiety, obesity and periodontal disease in smokers and non-smokers: A cross-sectional study. J Dent Res Dent Clin Dent Prospects 2016;10(4):234-240.
• 61. Jaiswal R, Shenoy N, Thomas B. Evaluation of association between psychological stress and serum cortisol levels in patients with chronic periodontitis - Estimation of relationship between psychological stress and periodontal status. J Indian Soc Periodontol 2016;20(4):381-385.
• 62. Castro GDC, Oppermann RV, Haas NA, Winter R, Alchieri JC. Association between psychosocial factorsand periodontitis: A case-control study. J Clin Periodontol 2006;33:109-114.
• 63. Peruzzo DC, Benatti BB, Ambrosano GM, et al. A systematic review of stress and psychological factors as possible risk factors for periodontal disease. J Periodontol 2007;78(8):1491-1504.
• 64. Mengel R, Bacher M, Flores-De-Jacoby L. Interactions between stress, interleukin-1beta, interleukin-6 and cortisol in periodontally diseased patients. J Clin Periodontol 2002;29(11):1012-22.
• 65. Karimi M, Elyahoo S, Golchin, L, Kermani T. Relationship be-tween stress, anxiety, depression and salivary IgA with periodon-tal disease. Bioscience Biotechnology Research Communications 2017;10, 88–92.
• 66. Katuri KK, Dasari AB, Kurapati S, Vinnakota NR, Bollepalli AC, Dhulipalla R. Association of yoga practice and serum cortisol levels in chronic periodontitis patients with stress-related anxiety and depression. J Int Soc Prev Community Dent 2016;6(1):7-14.
• 67. Laforgia A, Corsalini M, Stefanachi G, Pettini F, Di Venere D. Assessment of Psychopatologic Traits in a Group of Patients with Adult Chronic Periodontitis: Study on 108 Cases and Analysis of Compliance during and after Periodontal Treatment. Int J Med Sci 2015;12(10):832-839.
• 68. Kesim S, Unalan D, Esen C, Ozturk A. The relationship between periodontal disease severity and state-trait anxiety level. J Pak Med Assoc 2012;62(12):1304-8.