Department for Extended Treatment and Palliative Care of Men, University Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia.
Research Unit "Dr. Mirko Grmek", University Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia.
Clin Exp Dent Res. 2022 Feb;8(1):366-373. doi: 10.1002/cre2.492. Epub 2021 Nov 3.
The efficacy of treatment of major depressive disorder (MDD) is not satisfactory. Systemic inflammation may play an important role in MDD pathogenesis and treatment outcomes. Periodontal disease is the systemic inflammatory condition. Its prevalence may be as high as 45%. We aimed to assess the association of periodontal status with the outcome of 3-month first-line treatment of MDD with selective serotonin reuptake inhibitors.
We performed the prospective cohort study during 2018/2019 at Psychiatric Hospital "Sveti Ivan," Croatia, on a consecutive sample of 43 patients. The outcome was the MDD symptoms severity measured using the Hamilton Depression Rating Scale-17. The periodontal status was indicated by the clinical attachment loss (CAL).
Baseline periodontal status had a nonlinear significant and clinically relevant association with the MDD treatment outcome (R change of the quadratic term = 0.12; p = 0.027). In patients with good baseline periodontal status the severity of MDD symptoms was significantly improved. When the value of CAL was ≥4.44 mm, indicating the worse periodontal status, further increase in baseline CAL was associated with the worsening of MDD treatment outcomes independently of the baseline depression severity and 14 sociodemographic and clinical predictors of treatment outcome.
Periodontal healthcare is accessible, and should be utilize in an integrative, multidisciplinary approach not only for the sake of psychiatric patients' quality of life and prevention of periodontal disease, but for the sake of the outcomes of psychiatric treatment as well.
重度抑郁症（MDD）的治疗效果并不令人满意。全身炎症可能在 MDD 的发病机制和治疗结果中起重要作用。牙周病是一种全身性炎症疾病，其患病率可能高达 45%。我们旨在评估牙周状况与选择性 5-羟色胺再摄取抑制剂（SSRIs）治疗 MDD 三个月一线治疗结果的相关性。
我们在 2018/2019 年期间在克罗地亚的斯韦蒂·伊万精神病院进行了这项前瞻性队列研究，纳入了连续的 43 名患者。结局是使用汉密尔顿抑郁评定量表-17 测量的 MDD 症状严重程度。牙周状况由临床附着丧失（CAL）表示。
基线牙周状况与 MDD 治疗结果呈显著非线性相关，且具有临床意义（二次项的 R 变化=0.12；p=0.027）。在基线牙周状况良好的患者中，MDD 症状的严重程度显著改善。当 CAL 值≥4.44 mm 时，表明牙周状况较差，进一步增加基线 CAL 与 MDD 治疗结果恶化独立相关，与基线抑郁严重程度以及 14 项治疗结果的社会人口学和临床预测因素无关。
牙周保健是可行的，应在综合、多学科的方法中利用，不仅为了精神病患者的生活质量和预防牙周病，也为了精神病治疗的结果。
