Validation of the HADS and PSS‐10 and psychological status in patients with oral lichen planus

Wiriyakijja, Paswach; Porter, Stephen; Fedele, Stefano; Hodgson, Tim; McMillan, Roddy; Shephard, Martina; Ríordáin, Rícheal Ní

doi:10.1111/odi.13220

Cited by 27 publications

(28 citation statements)

References 54 publications

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“…A significantly higher number of non-alcohol drinkers with RAS in this study have depressive symptoms when compared to those who consume alcohol. This finding matched several studies in different conditions including oral lichen planus, 28 which found the increased risk of having depressive symptoms among non-alcohol drinkers. One possible explanation of this association might be a result of certain social confounding factors.…”

Section: Discussionsupporting

confidence: 91%

Validation of the HADS and PSS‐10 and a cross‐sectional study of psychological status in patients with recurrent aphthous stomatitis

Wiriyakijja

Porter

Fedele

et al. 2020

J Oral Pathology Medicine

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Objectives To validate the Hospital Anxiety and Depression Scale (HADS) and the 10‐item Perceived Stress Scale (PSS‐10) for use in clinical studies of recurrent aphthous stomatitis (RAS) and to provide cross‐sectional assessment of anxiety, depressive, and distress symptoms and perceived stress in patients with RAS. Methods The validity and reliability of the HADS and PSS‐10 were evaluated in 120 individuals with RAS through confirmatory factor analysis and calculation of Cronbach's alpha and omega coefficients. The prevalence of comorbid anxiety, depression, distress, and moderate‐to‐high perceived stress, and their association with demographics and clinical factors were assessed through cutoff scores of the HADS and PSS‐10 and bivariate analyses, respectively. Results A bi‐factor model, with all items loading onto general factor with two group factors, provides the best fit to the HADS and PSS‐10 data of this RAS cohort. While omega values suggested adequate reliability of total score of both scales, relatively low ranges of coefficient omega hierarchical limit utility of their subscale scores. The prevalence of anxiety, depression, distress, and moderate‐to‐high perceived stress was 42.5%, 18.33%, 28.33%, and 71.67%, respectively. Ethnicity, alcohol consumption, disease comorbidities, clinical type of RAS, ulcer size, pain, and RAS disease activity were found to be associated with negative psychological symptoms. Conclusion The HADS and PSS‐10 are valid and reliable as general scales of psychological distress and stress in patients with RAS. Significant mental burden among RAS patients makes the use of these validated instruments a sensible and prudent practice for psychological assessment of this patient group.

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Section: Discussionsupporting

confidence: 91%

Validation of the HADS and PSS‐10 and a cross‐sectional study of psychological status in patients with recurrent aphthous stomatitis

Wiriyakijja

Porter

Fedele

et al. 2020

J Oral Pathology Medicine

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“…One third of patients with OLP have psychological comorbidities like anxiety, depressive or distress symptoms [ 33 – 35 ]. It is believed that autoimmune diseases influence the psyche of affected patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of oral lichen planus and its causal context with dental restorative materials and oral health-related quality of life

et al. 2021

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Background The aim of this study was to investigate the influence of clinical characteristics and dental restorative materials on oral health-related quality of life in patients with oral lichen planus. In particular, the influences of amalgam and metals were investigated. Methods A total of 112 patients with clinical and histological features of oral lichen planus from the Department of Cranio-Maxillofacial Surgery at the University Hospital of Münster participated in this prospective study. Clinical parameters of oral lichen planus and the dental restorative materials used were evaluated. Oral health-related quality of life was investigated by using the short form of the German version of the Oral Health Impact Profile (OHIP-14). In addition, physical pain was rated on a visual analogue scale. Results The average OHIP-14 score was 13.54. A high correlation was seen between OHIP and pain. Likewise, higher OHIP-values were seen for male patients, and such as for those patients with non-reticular forms of oral lichen planus (OLP). A local form of OLP is more often seen on female patients, such as with the presence of reticular lichen. In regard to the restorations, the presence of composite restorations is correlated with a local lichen, whereas the presence of gold restorations is often seen with a generalized lichen. Furthermore, the grading of strength of association between mucosal lesion and amalgam/metal was tested. No significant differences revealed the analysis of the relationship between gender, clinical form of OLP, age, and presentation form between the 4 gradings of Thornhill. Conclusions The oral health-related quality of life is significantly limited in patients with oral lichen planus. But these OHIP scores are not influenced by the restorative materials. Here, pain severity is the most important aspect. We found no statistical differences in the clinical parameters between patients with amalgam or metal restoration and patients without these restorations. It is not necessary to replace amalgam fillings that are not in direct contact with mucosal surfaces.

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“…Anxiety and depression are common cofactors in OLP [ 25 ]. In a study by Wiriyakijja et al, prevalences of anxiety, depression and distress were 39.23%, 20.77% and 27.69%, respectively [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Signs of anxiety, depression and distress were examined in a study by Wiriyakijja et al One-third of 260 patients named psychological complaints. Patients with these mental concomitant diseases had significantly more frequent physical pain in the mouth area than patients without concomitant diseases [ 26 ]. As already known for other chronic diseases, somatic complaints have an impact on the psyche [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Does the Clinical Form of Oral Lichen Planus (OLP) Influence the Oral Health–Related Quality of Life (OHRQoL)?

Daume

Kreis

Bohner

et al. 2020

IJERPH

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(1) Background: The aim of the study was to investigate the oral health–related quality of life (OHRQoL) of patients with oral lichen planus (OLP) and to evaluate differences between the various clinical forms of OLP. Specifically, the differences in OHRQoL, physical pain levels and eating restriction were assessed; (2) Methods: One hundred and twelve patients with clinical and histological features of OLP from the Department of Cranio-Maxillofacial Surgery of the Münster University Hospital participated in this prospective study. OHRQoL was analysed by using the German short version of the Oral Health Impact Profile (OHIP-14). Physical pain levels and restriction in eating were rated on visual analogue scales (VAS). The statistical analysis was performed using the Mann–Whitney U-Test and the chi-squared test with a significance level at p = 0.05; (3) Results: Group 1 consisted of patients with reticular OLP (n = 50) and group 2 of patients with atrophic, erosive-ulcerative or bullous OLP (n = 62). The average OHIP-14 score was 13.54 points and differed significantly between the two groups. There were significant differences in the domains “physical pain”, “psychological discomfort”, “physical disability” and “social disability”. The VAS “physical pain” score and “restriction in eating” score varied significantly between the clinical forms. Positive correlations were found between the OHIP-14 total scores and the VAS scores; (4) Conclusion: The OHRQoL is significantly limited in patients with OLP; especially, patients with erosive-ulcerative OLP are affected.

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Validation of the HADS and PSS‐10 and psychological status in patients with oral lichen planus

Cited by 27 publications

References 54 publications

Validation of the HADS and PSS‐10 and a cross‐sectional study of psychological status in patients with recurrent aphthous stomatitis

Validation of the HADS and PSS‐10 and a cross‐sectional study of psychological status in patients with recurrent aphthous stomatitis

Clinical characteristics of oral lichen planus and its causal context with dental restorative materials and oral health-related quality of life

Does the Clinical Form of Oral Lichen Planus (OLP) Influence the Oral Health–Related Quality of Life (OHRQoL)?

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