Characteristics of the psychopathological status of oral lichen planus: a systematic review and meta‐analysis

Abstract

Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa having no clear aetiology or pathogenesis. The influence of psychological disturbances on OLP has been widely discussed but still bears the controversy. This study aimed at assessing scientific evidence between the OLP and psychological alterations of the patient. We searched seven important databases for studies on OLP and psychological factors (anxiety, depression, stress, sleep disorders, etc.) published between 1 January 2000, and 1 October 2020. Case‐control and cross‐sectional studies were incorporated into this study. The meta‐analysis used a random‐effects model assessed by using the I2 statistic. Dichotomous variables used the odds ratio and 95% confidence interval (CI), and continuous variables used the mean difference with 95% CI. Finally, 26 studies were included in the review. A meta‐analysis of 13 studies showed there was a significant association of OLP with anxiety, depression and stress compared with healthy controls. Certain personality characteristics and sleep disorders also influence the patient of OLP. Therefore, psychological and psychiatric examinations should be carried out routinely for patients with OLP and improve the prognosis of the disease. © 2022 Australian Dental Association

Exploring the Relationship between Psychoneuroimmunology and Oral Diseases: A Comprehensive Review and Analysis

“…Despite establishing a psychosomatic connection, the underlying mechanisms that mediate the relationship between psychosocial stress and OLP remain poorly understood. A review of immuno-neuro-endocrine interactions in OLP yielded inconsistent findings regarding the involvement of the HPA axis: 55.55% of studies reported higher salivary cortisol concentrations in OLP patients compared to healthy controls, and 33.33% and 11.11% showing no difference and lower cortisol concentrations respectively in OLP patients [ 25 ]. Similarly, another study detected elevated serum cortisol only in patients with erosive lesions, and not in those with reticular lesions suggesting that cortisol levels may be predictive of the severity of the disease [ 26 ].…”

On the Role of Psychoneuroimmunology in Oral Medicine

“…Previous research has also found evidence of the pathogenic relevance of psychobiological components to the course and prognosis of OLP. 28 , 64 , 66 For example, in controlled studies, patients with OLP showed increased levels of psychosocial stress, depression and anxiety, 67 , 68 , 69 , 70 , 71 less effective coping, 72 and more stressful life events. 73 , 74 In addition, patients with OLP have been shown to score high in certain personality traits.…”

“…73 , 74 In addition, patients with OLP have been shown to score high in certain personality traits. 71 Specifically, patients with OLP are very norm-conscious, conservative, not very emotional, and highly self-controlled (16 Personality Factor Questionnaire [16PF]). 75 They also have higher levels of depression and tend to somatise, that is, react with physical symptoms in psychologically stressful situations (Minnesota Multiphasic Personality Inventory [MMPI]).…”

Correlations between schizophrenia and lichen planus: a two-sample bidirectional Mendelian randomization study

“…LP may be accompanied by psychiatric comorbidities, and multivariable analysis has demonstrated a positive correlation between LP and an increased likelihood of depression and anxiety ( 18 ). Furthermore, schizophrenia has been found to significantly influence the development and severity of LP ( 19 ), with research indicating a correlation between schizophrenia and the occurrence of oral lichen planus ( 20 – 22 ). The pathogenesis of LP is influenced by various factors, including individual patients and their potential etiology.…”