RESUMEN
BACKGROUND: Stress and depression may affect the onset and progression of periodontal disease. However, to the best of our knowledge, no published study has established whether the mechanisms by which stress and depression influence periodontal disease are physiologic, behavioral, or both. This cross-sectional pilot study explored the associations between psychologic factors, markers of periodontal disease, psychoneuroimmunologic variables, and behavior. METHODS: This study included 45 periodontal patients referred by three dentists. Participants completed composite health, chronic stress, depression, and demographic questions, and salivary cortisol (CORT) was measured. A hygienist assessed the magnitude of periodontal disease. RESULTS: Stress, depression, and CORT were correlated with measures of periodontal disease. In addition, oral care neglect during periods of stress and depression was associated with attachment loss and missing teeth. After controlling for age, family history, and brushing frequency, depression and CORT were significant predictors of the number of missing teeth. A similar model also predicted the number of teeth with clinical attachment loss >5 mm. CONCLUSIONS: Stress and depression may be associated with periodontal destruction through behavioral and physiologic mechanisms. Addressing psychologic factors, such as depression, may be an important part of periodontal preventive maintenance.
Asunto(s)
Depresión/complicaciones , Hidrocortisona/metabolismo , Periodontitis/etiología , Estrés Psicológico/complicaciones , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Hidrocortisona/análisis , Masculino , Persona de Mediana Edad , Higiene Bucal , Proyectos Piloto , Análisis de Regresión , Saliva/químicaRESUMEN
High expressed emotion (EE) attitudes among parents are associated with an increased likelihood of relapse among bipolar patients, but the origins of these attitudes are unclear. This study examined characteristics of bipolar disorder in adolescents that might be associated with high EE attitudes among parents. We hypothesized that an earlier onset of mood disorder and greater current illness severity would predict higher levels of criticism and emotional overinvolvement among parents. Demographic, diagnostic, and EE data were collected from interviews with parents of 44 bipolar adolescents (mean age 14.5 yrs.). Current illness severity and functioning were not associated with high-EE attitudes. Parents of girls, however, were more likely to be high in criticism than parents of boys. Parents of girls expressed more critical comments when the child had an adolescent compared to a childhood onset of bipolar disorder, whereas the reverse pattern was evident among parents of boys. We encourage prospective investigations of the developmental correlates of parental EE attitudes in larger, more heterogeneous samples of bipolar adolescents and children.