The Effect of Comorbid Somatic Pain and Psychiatric Disorder on Oral Health-Related Quality of Life in Patients with Malocclusion

Abstract

Background Malocclusion patients, as a population highly concerned with oral health-related quality of life (OHRQoL), are especially at risk of developing psychiatric disorders. Since somatic pains are frequently accompanied by psychiatric disorders, a growing body of research is starting to focus on this comorbidity in the orthodontic patient population. However, the relationships among somatic pains, psychiatric disorders, and impaired OHRQoL during orthodontic treatment remain unknown.Method In the current study, scale measurements including somatic pain (quantified by PHQ-15), mental disorders (quantified by HEI, PIDAQ, and SCL90), and OHRQoL (verified by OHIP-14) were collected from 769 outpatients in the orthodontic department. According to their reports of the presence or absence of somatic pain, respondents were divided into with symptoms and without symptoms groups. Variation analysis and correlation analysis were used to investigate the relationships among different clinical assessments. A chained mediation model was further conducted to explore the direct and indirect effects of these various clinical factors.Results The scores of HEI, SCL90, and OHIP-14 were significantly higher in the patients with somatic pain symptoms (P < 0.001). The higher PHQ-15-P and HEI scores remained as statistically significant predictors of lower OHIP-14 scores (P < 0.001). Anxiety and depression partially mediated the correlation between somatic pain and OHRQoL, of which the mediation effect of anxiety (52.9%) dominated the indirect effect.Conclusion Orthodontic Patients with somatic pain symptoms were at significantly higher risk for mental disorders and lower OHRQoL. Somatic pain can influence the orofacial system and was partially mediated by comorbid anxiety and depression. The comorbidity of somatic symptoms and psychological disorders influence the quality of life significantly and thus the prognosis of the orthodontic treatment.