Anxiety and depression scores in olp and non olp individuals / dental implant courses

Anxiety and Depression Scores in OLP and
Non-OLP Individuals
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

Anxiety and Depression Scores in OLP & non OLP Individuals
INTRODUCTION
▪ OLP: common chronic inflammatory mucocutaneous
disease affecting about 1% to 4% of general population.
ORAL LICHEN
PLANUS
SYMPTOMS
i.e. BURNING
SENSATION
&
PAIN
PSYCHOSOMATIC
FACTORS
VICIOUS CYCLE

REVIEW OF LITERATURE
▪ Andreasen first to point out in 1968 that OLP patients are found to
be in conditions of stress leading to anxiety and depression.
▪ Colella et al applying the Hamilton scale, found anxiety as well as
depression in patients with OLP.
▪ McCartan, Jose L, Rojo-Moreno carried out trials to prove the
same.
▪ Hegarthy AM, Hodgson A suggested that oral lichen planus does
affect quality of life, & effective treatment improves patient well-
being.

Indian Dental academy
• www.indiandentalacademy.com
• Leader continuing dental education
• Offer both online and offline dental
courses

AIMS
1. To evaluate the levels of psychological status in oral
lichen planus individuals.
2. To evaluate the impact of treatment in psychosocial status
in oral lichen planus individuals.

METHODS AND MATERIALS
Study Setting: Dept. of Oral Medicine and Radiology,
Bharati Vidyapeeth Dental College and
Hospital, Pune.
Study Population:
Inclusion criteria for OLP participants
- Self reporting individuals, 18 years & above, clinically &
histologically proven oral lichen planus.
- Burning sensation as one of the presenting symptoms.

Inclusion criteria for non-OLP participants
- Otherwise healthy individuals reporting with dental
complaint of short duration, age and gender matched to
OLP participants.
18 OLP (Group OLP) and 18 normal individuals (Group Non-
OLP), age and gender matched to OLP participants were
enrolled in the study.

‘‘The Hospital Anxiety & Depression Scale’’
▪ Validity of HADS was assessed by Ingvar Bjelland, Alv A
Dahl et al in 2001 and HADS was found to perform well in
assessing the anxiety disorders and depression in both
somatic, psychiatric & primary care patients and in the
general population.

‘’The Hospital Anxiety & Depression Scale’’
Hospital Anxiety and Depression Questionnaire was
administered to all 18 OLP (start of therapy) & 18 Non-OLP
individuals.
Hospital Anxiety and Depression Questionnaire was
administered to 10 (Group A) and 6 (Group P) at the end of
the therapy

▪ Questionnaire consists of
14 questions; 7 questions
pertaining to anxiety & 7
pertaining to depression.
▪ Each item has to answered
on a four point (0-3)
response category.
▪ 0-7=No anxiety/depression
8-10=Mild anxiety/depression
≥11=Frank anxiety/depression

RESULTS AND DISCUSSION
From the ‘‘HAD Questionnaire’’, data were further sorted into
tables and analyzed to achieve the aims of the study.

Table 1: Levels of psychological status in oral lichen planus
individuals
Groups Group OLP Total
Absent Mild Frank
Anxiety 06
(33.33%)
03
(16.66%)
09
(50%)
18
Depression 02
(11.11%)
01
(5.55%)
15
(83.33%)
18
Thus, 50% of the participants with OLP had ‘frank anxiety’, 83.33%
had ‘frank depression’.

Table 2: Levels of psychological status in normal individuals
Groups Group Non-OLP Total
Absent Mild Frank
Anxiety 18
(100%)
00
(0%)
00
(0%)
18
Depression 17
(94.44%)
01
(5.55%)
00
(0%)
18
None of the participant in the Non-OLP group had anxiety whereas
only 1 participant had mild depression.

Table 3a: Comparison of levels of psychological status in OLP and
Non-OLP individuals.
Groups Anxiety Total
Absent Mild Frank
Group
OLP
06
(33.33%)
03
(16.66%)
09
(50%)
18
Group
Non-OLP
18
(100%)
00
(0%)
00
(0%)
18
Thus, anxiety is more prevalent in OLP individuals (66.66%) as
compared to Non-OLP individuals (0%).

Table 3b: Comparison of levels of psychological status in OLP and
Non-OLP individuals
Groups Depression Total
Absent Mild Frank
Group
OLP
02
(11.11%)
01
(5.55%)
15
(83.33%)
18
Group
Non-OLP
17
(94.44%)
01
(5.55%)
00
(0%)
18
Depression (88.88%) like anxiety too is more common in OLP as
compared to Non-OLP individuals (5.55%).

OLP Group (18 participants)
10 were given 2 were assessed
‘active’ intervention 6 were given only at baseline
(Group A) ‘placebo’ intervention
(Group P)

Table 4a: Comparison of the prevalence of anxiety in OLP individuals
before and after getting ‘active’ intervention.
Absent Mild Frank
Group A
Before 4 (40%) 2 (20%) 4 (40%)
10
After 7 (70%) 2 (20%) 1 (10%)
Thus, on receiving active intervention the anxiety scores in OLP
individuals dropped from 6 participants having combination of mild
and frank anxiety to 3 participants. After active intervention 7
participants were relieved of anxiety as compared to 4.

Table 4b: Comparison of the prevalence of depression in OLP
individuals before and after getting ‘active’ intervention.
Absent Mild Frank
Group A
Before 0 (0%) 1 (10%) 9 (90%)
10
After 5 (50%) 4 (40%) 1 (10%)
Thus, on getting active intervention the depression present in all 10;
1 (10%) mild and 9 (90%) frank came down 1 (10%) and 4 (40%)
mild. 5 (50%) participants were completely relieved of depression.

Table 5a: Comparison of the prevalence of anxiety in OLP individuals
before and after getting ‘placebo’ intervention.
Absent Mild Frank
Group P
Before 1
(16.66%)
1
(16.66%)
4
(66.66%) 6
After 2
(33.33%)
1
(16.66%)
3
(50%)
Not much change in anxiety registered in group receiving passive
intervention before and after the intervention .

Table 5b: Comparison of the prevalence of depression in OLP
individuals before and after getting ‘placebo’ intervention.
Absent Mild Frank
Group P
Before 1
(16.66%)
0
(0%)
5
(83.33%) 6
After 1
(16.66%)
0
(0%)
5
(83.33%)
No change in depression in OLP individuals before and after getting
passive intervention

Table 6a: Comparison of anxiety in Group A and Group P after getting
respective intervention.
Absent Mild Frank
Group A Before 4 (40%) 2 (20%) 4 (40%)
10After 7 (70%) 2 (20%) 1 (10%)
Group P
Before 1 (16.66%) 1(16.66%) 4 (66.66%)
6
After 2 (33.33%) 1(16.66%) 3 (50%)

Table 6b: Comparison of depression in Group A and Group P after
getting respective intervention.
Absent Mild Frank
Group A Before 0 (0%) 1 (10%) 9 (90%)
10After 5 (50%) 4 (40%) 1 (10%)
Group P
Before 1(16.66%) 0 (0%) 5 (83.33%)
6
After 1(16.66%) 0 (0%) 5 (83.33%)

CONCLUSIONS
1. High level of anxiety (50%) and depression (83.33%)
was observed in participants with OLP as compared to
Non-OLP (0%).
2. A marked decrease in anxiety (from 40% to 10%) and
depression (from 90% to 10%) was noted in participants
with OLP after being given ‘active intervention’ as
compared to the ‘placebo’ where hardly any change in
anxiety and depression was noted.

ACKNOWLEDGEMENTS
▪ Dept. of Oral Medicine & Radiology,
BVU Dental College & Hospital, Pune.
▪ Dept. of Oral & Maxillofacial Surgery,
▪ Dept. of Oral Pathology,
▪ Last but not the least my sincere thanks to My Patients to
whom I owe this work.

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