Anxiety and depression in keratotic oral lichen planus: a multicentric study from the SIPMO

Abstract

Objectives Oral lichen planus with exclusive keratotic reticular, papular, and/or plaque-like lesions (K-OLP) is a clinical pattern of OLP that may be associated with a complex symptomatology and psychological alteration. The aim of the study was to evaluate the prevalence of anxiety (A) and depression (D) in patients with K-OLP, analyzing the potential predictors which can affect mental health status. Methods Three hundred K-OLP patients versus 300 healthy controls (HC) were recruited in 15 Italian universities. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), and Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A) were administered. Results The K-OLP patients showed statistically higher scores in the NRS, T-PRI, HAM-D, and HAM-A compared with the HC (p-value < 0.001**). A and D were found in 158 (52.7%) and 148 (49.3%) K-OLP patients. Strong linear correlations were identified between HAM-A, HAM-D, NRS, T-PRI, and employment status and between HAM-D, HAM-A, NRS, T-PRI, employment status, and female gender. Multivariate logistic regression revealed that HAM-D and HAM-A showed the greatest increase in the R2 value for A and D in the K-OLP patients, respectively (DR2 = 55.5% p-value < 0.001**; DR2 = 56.5% p-value < 0.001**). Conclusions The prevalence of A and D is higher in the K-OLP patients compared with the HC, also found in K-OLP subjects without pain, suggesting that the processing of pain may be in a certain way independent of the processing of mood. Clinical relevance Mood disorders and pain assessment should be carefully performed in relation to K-OLP to obtain a complete analysis of the patients.

Bidirectional Association between Lichen Planus and Hepatitis C—An Update Systematic Review and Meta-Analysis

“…Literature yielded a total of 18,491 references, and once duplicates were excluded ( n = 5822), 234 studies were full-text reviewed. In total, 192 studies were included in the systematic review, of which 99 studies were included in the quantitative analysis, shown in Figure 1 [ 8 , 10 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , …”

“…When considering studies with only lichen planopilaris, the prevalence was 0.87% (HCV 3/342) [ 134 , 156 ]. Detailed information on the sample to the included studies is provided in Supplementary Table S2 [ 8 , 10 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , …”

“…The risk in patients with cutaneous and variant LP (with or without mucous location) was higher (OR 5.95; 95% CI, 4.09–8.66) than that observed in patients with predominantly or only oral location (OR 3.49; 95% CI, 2.00–4.87) [ 8 , 10 , 25 , 26 , 27 , 30 , 32 , 36 , 37 , 38 , 40 , 41 , 47 , 50 , 51 , 52 , 55 , 57 , 61 , 68 , 69 , 72 , 73 , 75 , 76 , 77 , 78 , 79 , 81 , 84 , 89 , 92 , 93 , 94 , 95 , 96 , 98 , 101 , 102 , 103 , 109 , 110 , 117 , 118 ].…”

Neuroticism and Psychological Stress in Patients Suffering Oral Lichen Planus: Research Evidence of Psycho-Stomatology?

“…Čanković et al conclude that the degree, number, and type of stressful changes experienced play an essential role in the onset or reactivation of OLP [ 23 ]. Interestingly, and despite OLP patients showing a higher frequency of depression than the general population [ 9 ], the majority of OLP patients are unaware that they are suffering from anxiety or depression; consequently, they had never had a psychiatric evaluation [ 16 ]. Our data showed slightly more patients with high stress in the case group.…”

“…OLP has periods of relapses and remissions, and exacerbations [ 11 , 14 , 15 ]; the last one is related to periods of psychological stress and anxiety [ 9 , 10 ]. Erosive OLP is considered a potentially malignant oral mucosa disorder, with a risk of progression to cancer of 0–10% [ 16 , 17 ]. A systematic review and meta-analysis reported malignant transformation rates of 1.14%.…”