Royal Adelaide Hospital, Adelaide, South Australia, Australia.
School of Dentistry and Oral Health, Griffith University, Southport, Queensland, Australia.
Community Dent Oral Epidemiol. 2019 Jun;47(3):267-273. doi: 10.1111/cdoe.12454. Epub 2019 Mar 20.
To investigate the controlled direct effect (CDE) of common mental disorders (CMD) on xerostomia which is not mediated by psychoactive medication intake.
A population-based cross-sectional study was conducted with 1720 individuals aged 20-59 years from Florianópolis, Brazil, in 2009. A two-stage cluster sample design was adopted, with a systematic selection of census tracts, followed by a random selection of households. All inhabitants of the selected households belonging to the age group of interest were considered eligible to participate. CMD were assessed using the Self-Reporting Questionnaire (SRQ > 7). Xerostomia was the outcome assessed by asking: "How often do you feel dry mouth?" with responses "often" and "always" taken as indicating xerostomia. Psychoactive medication intake was set as the mediator. Confounding factors included sex, age, per capita family income, educational attainment and smoking status. Marginal structural models were performed to quantify the CDE of CMD on xerostomia. Missing data were handled by multiple imputation by chained equations, and sensitivity analysis for unmeasured confounding was carried out.
The overall prevalence of xerostomia was 8.8% and 15.3% of the individuals presented with CMD. After adjustment, the prevalence of xerostomia among individuals with CMD was 3.2 times higher than that among individuals without CMD (PR = 3.2 [95% CI: 2.3; 4.5]). The CDE of CMD on xerostomia which is not mediated by the medication intake resulted in a three times greater prevalence of xerostomia (PR = 3.0 95% CI: 2.0; 4.5) among those individuals with CMD.
Common mental disorders is directly and negatively associated with xerostomia. Clinicians should bear in mind the emotional state when investigating the underlying factors and managing patients with xerostomia.
调查心境障碍（CMD）对口腔干燥症的直接控制效应（CDE），这种效应不受精神活性药物摄入的影响。
2009 年，在巴西弗洛里亚诺波利斯开展了一项基于人群的横断面研究，纳入了 1720 名 20-59 岁的个体。采用两阶段聚类抽样设计，先对普查区进行系统抽样，然后对家庭进行随机抽样。属于感兴趣年龄组的所有被选中家庭的居民都有资格参加。使用自报告问卷（SRQ＞7）评估 CMD。口腔干燥症的结果通过询问：“您多久感到口干一次？”，回答“经常”和“总是”表示口腔干燥症。精神活性药物摄入被设定为中介。混杂因素包括性别、年龄、人均家庭收入、教育程度和吸烟状况。采用边际结构模型来量化 CMD 对口腔干燥症的 CDE。通过链方程的多重插补处理缺失数据，并进行了未测量混杂的敏感性分析。
口腔干燥症的总患病率为 8.8%，15.3%的个体存在 CMD。调整后，CMD 个体的口腔干燥症患病率是无 CMD 个体的 3.2 倍（PR=3.2[95%CI：2.3；4.5]）。CMD 对口腔干燥症的 CDE，即不受药物摄入影响的 CDE，导致 CMD 个体口腔干燥症的患病率增加了 3 倍（PR=3.0[95%CI：2.0；4.5]）。
心境障碍与口腔干燥症直接相关，呈负相关。当调查口腔干燥症的潜在因素和管理患者时，临床医生应牢记患者的情绪状态。
