Ivanovski Kiro, Nakova Marija, Warburton Gary, Pesevska Snezana, Filipovska Angelina, Nares Salvador, Nunn Martha E, Angelova Dragana, Angelov Nikola
Department of Oral Diseases and Periodontology, Faculty of Dentistry, University "St Kiril and Metodi," Skopje, Macedonia.
J Clin Periodontol. 2005 Oct;32(10):1034-40. doi: 10.1111/j.1600-051X.2005.00829.x.
Oral lichen planus (OLP) is an oral lesion with an enigmatic etiology. To explore the possibility of psycho-somatization, we evaluated the psychological personality profiles of OLP patients.
Twenty patients with reticular; 20 with erosive form of OLP, and 25 controls were tested with the psychological Minnesota Multiphasic Personality Inventory (MMPI)-202 test. Eight clinical scales (hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania) as well as cortisol level, CD3, CD4, CD8, and CD16 markers by group were compared. Psychosomatization was evaluated by the use of internalization ratio (IR) Index.
A characteristic MMPI profile was noted in the OLP groups with high IR index value. Significant differences among the groups were detected for cortisol, CD4, CD8, and CD16 counts. Mean values for hypochondriasis, depression, and hysteria were all significantly different with significantly higher mean scores for both reticular and erosive OLP subjects compared with controls.
Prolonged emotive stress in many OLP patients may lead to psychosomatization and may contribute to the initiation and clinical expression of this oral disorder.
If additional research involving a larger and more diverse sample of patients confirms these findings, clinical trials will be needed to determine whether adjunctive psychological intervention provides a benefit in treating patients with OLP.
口腔扁平苔藓（OLP）是一种病因不明的口腔病变。为了探究心身疾病化的可能性，我们评估了OLP患者的心理人格特征。
对20例网状型OLP患者、20例糜烂型OLP患者和25名对照者进行明尼苏达多相人格调查表（MMPI）-202心理测试。比较了八类临床量表（疑病、抑郁、癔症、精神病态偏差、偏执狂、精神衰弱、精神分裂症和轻躁狂）以及各组的皮质醇水平、CD3、CD4、CD8和CD16标志物。采用内化率（IR）指数评估心身疾病化情况。
OLP组的MMPI特征表现为IR指数值较高。在皮质醇、CD4、CD8和CD16计数方面，各组间存在显著差异。疑病、抑郁和癔症的平均值均有显著差异，网状型和糜烂型OLP患者的平均得分均显著高于对照组。
许多OLP患者长期的情绪应激可能导致心身疾病化，并可能促使这种口腔疾病的发生和临床表现。
如果涉及更多样化的更大样本患者的进一步研究证实了这些发现，将需要进行临床试验以确定辅助心理干预是否对治疗OLP患者有益。
