Academic literature on the topic 'Oral Anxiety Disorders'

IntroductionResearch has highlighted relationships between the micro-organisms that inhabit our gastrointestinal tract (oral and gut microbiota) with host mood and gastrointestinal functioning. Mental health disorders and functional gastrointestinal disorders co-occur at high rates, although the mechanisms underlying these associations remain unclear. The Bugs and Brains Study aims to investigate complex relationships between anxiety/depression and irritable bowel syndrome (IBS) in two ways. First, its primary component will compare the gut and oral microbiota in females with anxiety/depression and/or IBS relative to controls, and investigate underlying physiological, endocrine and immune factors, as well as associations with diet and psychosocial factors. In an ancillary component, the study will also investigate gastrointestinal and mental health symptoms in a larger sample, and explore relationships with diet, exercise, oral health, substance use, medical history, early life adversity and psychosocial factors.Methods and analysisThe Bugs and Brains Study aims to recruit 160 females to the primary component: (1) 40 controls; (2) 40 participants with a depressive/anxiety disorder, but no IBS; (3) 40 participants with IBS, but no depressive/anxiety disorder and (4) 40 participants with both depressive/anxiety disorder and IBS. Participation is completed within 1 month, and involves comprehensive questionnaires, anthropometrics, a diagnostic clinical interview, collection of two saliva samples, and stool, urine and hair samples. This study aims to use a systems biology approach to characterise oral and gut microbial composition and function using 16S rRNA gene sequencing and nuclear MR spectroscopy. As part of the ancillary component, it will collect questionnaire data from 1000 participants aged 18–40 years, capturing mental health, gastrointestinal health, oral health, diet and psychosocial factors.Ethics and disseminationApproval was granted by the University of Melbourne Human Research Ethics Committee (#1749221). All participants voluntarily provided informed consent. Results will be published in peer-reviewed journals and presented at scientific conferences.

Background. Probiotic oral intake, via modulation of the microbiota-gut-brain axis, can impact brain activity, mood, and behavior; therefore, it may be beneficial against psychological distress and anxiety disorders. Inflammatory cytokines can influence the onset and progression of several neurodegenerative mood disorders, and the IL-1β rs16944 SNP is related to high cytokine levels and potentially affects mood disorders. The aim of this study was to examine the combined effect of IL-1β polymorphism and probiotic administration in mood disorder phenotypes in the Italian population. Methods. 150 subjects were randomized into two different groups, probiotic oral suspension group (POSG) and placebo control group (PCG), and received the relative treatment for 12 weeks. Psychological profile assessment by Hamilton Anxiety Rating Scale (HAM-A), Body Uneasiness Test (BUT), and Symptom Checklist 90-Revised (SCL90R) was administered to all volunteers. Genotyping was performed on DNA extracted from salivary samples. Results. After 12 weeks of intervention, a significant reduction of HAM-A total score was detected in the POSG (p<0.01), compared to the PCG. Furthermore, IL-1β carriers have moderate risk to develop anxiety (OR=5.90), and in POSG IL-1β carriers, we observed a reduction of HAM-A score (p=0.02). Conclusions. Consumption of probiotics mitigates anxiety symptoms, especially in healthy adults with the minor A allele of rs16944 as a risk factor. Our results encourage the use of probiotics in anxiety disorders and suggest genetic association studies for psychobiotic-personalized therapy.

<p> Most of the diseases mucous membranes of the mouth occur against a background of disorders of the nervous system. Anxiety disorders can complicate the course of dental pathology. For the assessment of anxiety and depression survey patients were conducted by scale hospital anxiety and depression hads. The studies allowed us to describe the patients with oral mucous diseases as suffering from anxiety disorders. To reduce the symptoms of anxiety disorders and timely correction of identified violations of all patients was appointed anksiolitic, on a background of reception of which the questionnaire noted significant decrease of the level of alarm and depression.</p><p> </p>

Many women in menopause experience discomfort in the oral cavity — burning, dysesthesia, xerostomia, taste changes, which lead to a reduction in the quality of life.Aim: to identify clinical and psychological factors associated with the development of burning mouth syndrome in menopausal women.Material and methods. Were examined 67 women aged 45–67 years. Assessment of oral pain performed using the Visual analog scale (VAS). Assessment of dry mouth symptoms severity performed using the Challacombe Scale of Clinical Oral Dryness (CSCOD). Psychometric tests was carried out with Spielberger’s Anxiety Test, Montgomery–Asberg Depression Rating Scale (MADRS), Hospital Anxiety and Depression Scale (HADS), Mini-Mental State Examination (MMSE). The Psychological stress measure-25 scale was also used to assess the impact of stress on somatic, behavioral, and emotional indicators of life. The quality of life was measured using the Oral Health Impact Profile-14 (OHIP-14).Results. Clinically, burning mouth syndrome in menopausal women manifested with various oral symptoms include paresthesias and pain in the tongue, oral cavity, as well as xerostomia and taste disorders. Painful sensations in the tongue developed 1–3 years after the menopause onset and was preceded by stressful life events. The pain scores on the VAS was 63.1 ± 11.8 mm. Depressive disorders were characterized by an average level of personal and situational anxiety, instability to stressful influences. The quality of life assessment in menopausal women using the OHIP-14 scale, the total score was 17.1 ± 5.21 points and corresponded to the sufficient quality of oral health.Conclusion. Burning mouth syndrome and neuropsychiatric disorders (anxiety, asthenia, depression, phobia, sleep disorders) in menopausal women are pathophysiologically related conditions.

Examination of the mental state of patients suffering from facial trauma is rarely ever recorded, let alone screening them for posttraumatic stress disorders (PTSDs) or generalized anxiety disorder. Providing early support to the patient in light of such psychological conditions can improve the overall quality of life. The aim of this study was to perform a literature review to assess the relation of mental state disorders to facial trauma in terms of their prevalence, assess screening methodology, and also to evaluate the prognosis of individuals subjected to psychological intervention/screening at an early stage of clinical examination. Research databases such as ScienceDirect, Google Scholar, PubMed, and Medline were searched using the keywords “psychological trauma,” “facial trauma,” and “PTSD.” Only meta-analyses, systematic reviews, and original research articles in the English language were included in the study. Correspondence to journal editors and clinician opinions were excluded from the study. Out of a total of 459 results, only 8 articles satisfied the inclusion criteria of the study. The literature review showed that patients suffering from orofacial trauma had significantly increased levels of mental state disorders such as PTSD and generalized anxiety disorder, more so in victims of assault. The results of this literature review clearly point toward an increased prevalence of mental state disorders in patients suffering from facial trauma, which warrants for early intervention in this regard to improve the quality of life of these patients.

Anxiety appears among the most frequent psychiatric disorders. During recent years, a growing incidence of anxiety disorders can be attributed, at least in part, to the modification of our eating habits. To treat anxiety disorders, clinicians use benzodiazepines, which unfortunately display many side effects. Herein, the anxiolytic-like properties of two natural products (αS1–casein hydrolysate and Gabolysat®) were investigated in rats and compared to the efficacy of benzodiazepine (diazepam). Thus, the conditioned defensive burying test was performed after a unique oral dose of 15 mg/kg, at two time-points (60 min and then 30 min post oral gavage) to show potential fast-onset of anxiolytic effect. Both natural products proved to be as efficient as diazepam to reduce the time rats spent burying the probe (anxiety level). Additionally, when investigated as early as 30 min post oral gavage, Gabolysat® also revealed a fast-anxiolytic activity. To date, identification of bioactive peptide, as well as how they interact with the gut–brain axis to sustain such anxiolytic effect, still remains poorly understood. Regardless, this observational investigation argues for the consideration of natural compounds in care pathway.

Objective: To evaluate the effect of a music intervention upon anxiety, blood pressure, and heart rate in adult patients with potentially malignant oral disorders. Methods: Eighty consecutive adults (mean age: 68.3 years) consulting a Unit of Oral Medicine (Murcia Spain) were randomized to a study group (n = 40) that listened to music through headphones during 10 min or to a control group (n = 40). Corah’s dental anxiety score, blood pressure, heart rate, oxygen saturation (oximetry), skin temperature, and salivation were recorded at different timepoints before and after patient consultation. Results: Significant pre- versus post-consultation reductions were observed in blood pressure (p < 0.001) and heart rate (p < 0.001), though not in temperature, salivation, and oxygen saturation (p > 0.05). There were no significant differences between the study group and the controls (p > 0.05). Conclusions: The applied music intervention had no apparent effect upon anxiety. Further studies using different music intervention strategies and/or analytic parameters are needed to explore the benefits of this approach to decreasing anxiety.

Fibromyalgia is a syndrome currently considered idiopathic and multifactorial rheumatic that causes an increase in muscle tension and is characterized by muscle pain and chronic fibrous tissues—widespread, fluctuating and migrating—associated with stiffness, asthenia, cognitive disorders, insomnia or sleep disorders, alterations in sensitivity to stimuli. In affected patients, there may be anxiety or depressive disorder development. The aim of this study is, with the help of an interdisciplinary team, to evaluate the correlations between this syndrome and oral health. A literature review was conducted, analyzing the most common scientific databases, more than 200 studies were obtained. Subsequently to the application of filters and revision by the authors, only 18 articles were considered eligible for this review. From the results, it is clear that the correlations between fibromyalgia and oral health mainly concern pain in the oro-maxillofacial district, especially in the temporomandibular joint. This certainly could help for faster diagnosis of the syndrome, which is currently difficult to identify.

7q11.23 duplication syndrome is a recently documented genetic disorder associated with severe speech delay, language delay, a characteristic facies, hypotonia, developmental delay, and social anxiety. Children with this syndrome demonstrate developmentally appropriate nonverbal pragmatic abilities in socially comfortable situations. Motor speech disorder (childhood apraxia of speech and/or dysarthria), oral apraxia, and/or phonological disorder, or symptoms of these disorders, are common, as are characteristics consistent with expressive language disorder. Intensive speech/language therapy is critical for maximizing long-term outcomes.

Objective:Alcohol use disorders and panic disorder co-occur at a rate that exceeds chance significantly. The underlying mechanism of alcoholism associated with anxiety has rarely been examined using experimental methodologies. The present study in healthy volunteers tested whether alcohol consumption reduces anxiety associated with a panic-challenge procedure (35% CO2 challenge).Methods:The study design was placebo-controlled, double-blind, randomized. Eight healthy volunteers were enrolled; all subjects had an alcohol and a placebo oral intake according to a crossover design. After each consumption the subjects underwent the 35% CO2 challenge and a series of anxiety symptom assessments.Results:After the alcohol intake, the subjects presented a significant reduction in the anxiety state associated with the challenge procedure. The Panic Symptom List score is significantly lower after alcohol intake (P = 0.032), as compared with the placebo, and the Visual Analogue Anxiety Scale shows a trend to be lower after alcohol intake (P = 0.111).Conclusions:Moderate doses of alcohol acutely decrease the response to a 35% CO2 challenge in healthy volunteers. These results lend support to the pharmacological anxiolytic effect of alcohol and suggest that this property may reinforce the drinking behaviour among those with high levels of anxiety.

Abstract Depression, anxiety and sleep disorders have been reported to be associated with low level of inflammation, i.e., low-grade inflammation, but mainly in males. The evidence has mainly been based on laboratory or clinical studies with small sample sizes or epidemiological studies with elderly subpopulations. In this study the association of low-grade inflammation with depression, anxiety, and sleep disturbances was investigated using the Northern Finland 1966 Birth Cohort (NFBC 1966). In women, the effect of hormonal factors, menopause and the use of oral contraceptives/hormone replacement therapy on the association between low-grade inflammation and depression was also studied by using the Pieksämäki Study data. In 31-year follow-up of NFBC 1966 (N=6007), the depressive and anxiety symptoms were assessed by Hopkins Symptom Checklist-25 (HSCL-25) and sleep disorders by 15-D questionnaires, while the marker of low-grade inflammation, plasma concentration of high sensitivity C-reactive protein (hs-CRP), was measured. In the Pieksämäki study a representative sample of inhabitants in the town of Pieksämäki were invited to clinical examination. Depressive symptoms were obtained by Beck’s Depression Inventory-21, and hs-CRP was measured (512 women). The results of this study revealed that at epidemiological level, elevated hs CRP levels of ≥1.0 mg/L increased the probability of current depressive symptoms of single depressive episode in the two highest subgroups (i.e., HSCL-25 mean scores ≥1.75 and ≥2.01) 1.4- and 1.7- fold in males, respectively. In addition, anxiety symptoms (HSCL-25 anxiety scale mean score ≥1.75) increased independently the probability of elevated hs-CRP levels (>3.0 mg/L) in males over 2-fold. Risk ratio of 1.3 was found for males with moderate to severe sleep disturbances and elevated hs-CRP levels (≥1.0 mg/L). Regarding females, a positive correlation between elevated hs-CRP levels and depressive symptoms was found only among peri- and postmenopausal women not using exogenous hormones. The results suggest that low-grade inflammation is associated not only with depression but also with anxiety and sleep disturbances in young adult men. In women, hormonal factors may have an effect on the association between low-grade inflammation and depression. Further investigations are called for to confirm these findings and furthermore, to determine the possible role of low-grade inflammation in the pathophysiology of these disorders
Tiivistelmä Depressio, ahdistuneisuushäiriöt ja unihäiriöt on yhdistetty elimistön matala-asteiseen tulehdustilaan, joskin pääasiallisesti vain miehillä. Tulosten yleistettävyyttä ovat rajoittaneet tutkimusten pienet otoskoot tai painottuminen iäkkäisiin väestöaineistoihin. Tässä tutkimuksessa selvitettiin matala-asteisen tulehduksen yhteyttä depressioon, ahdistuneisuuteen ja unihäiriöihin Pohjois-Suomen syntymäkohortti 1966 -aineistossa. Lisäksi Pieksämäki-tutkimuksen aineistossa selvitettiin naisilla menopaussin ja ehkäisyvalmisteiden/vaihdevuosihormonikorvaushoidon vaikutusta depression ja matala-asteisen tulehduksen väliseen yhteyteen. Pohjois-Suomen syntymäkohortti 1966 -tutkimuksen 31-vuotisseurannassa kartoitettiin 6007 henkilöltä masennus- ja ahdistuneisuusoireita Hopkins Symptom Checklist-25 -arviointiasteikolla (HSCL-25) ja unihäiriöitä 15-D-kyselyllä. Lisäksi mitattiin matala-asteisen tulehduksen mittarina käytetyn herkän C-reaktiivisen proteiinin (CRP) pitoisuus. Pieksämäki-tutkimuksessa edustava otos Pieksämäen asukkaista kutsuttiin kliiniseen tutkimukseen ja depressiivisiä oireita kartoitettiin Beckin 21-osioisella arviointiasteikolla ja mitattiin herkkä CRP (512 naista). Nuorilla aikuisilla miehillä, joiden herkkä CRP oli kohonnut (≥1.0 mg/l), todettiin 1.7-kertainen masennusoireiden riski, kun katkaisupisteenä käytettiin HSCL-25-kyselyn masennuskeskiarvopistettä ≥2.01. Ahdistuneisuusoireet (HSCL-25-kyselyn ahdistuneisuuskeskiarvopisteet ≥1.75) lisäsivät kohonneen herkän CRP:n riskiä (>3.0 mg/l) yli kaksinkertaiseksi miehillä. Keskivaikeasta tai vaikeasta unihäiriöstä kärsivillä todettiin 1.3-kertainen kohonneen herkän CRP:n (≥1.0 mg/l) riski. Naisilla positiivinen yhteys masennuksen ja kohonneen herkän CRP:n välillä todettiin vain peri- ja postmenopausaalisilla naisilla, jotka eivät käyttäneet hormonikorvaushoitoa tai suun kautta otettavia ehkäisyvalmisteita. Tutkimustulokset viittaavat matala-asteisen tulehduksen liittyvän depressioon, ahdistukseen ja unihäiriöön nuorilla aikuisilla miehillä. Naisilla hormonaaliset seikat mahdollisesti vaikuttavat depression ja matala-asteisen tulehduksen väliseen yhteyteen. Tulevaisuuden tutkimushaasteena on selvittää matala-asteisen inflammaation mahdollinen merkitys depression, ahdistuneisuuden ja unihäiriöiden patofysiologiassa

Este estudo teve por objetivo investigar a associação transtornos de ansiedade e depressão e do uso de medicamentos com o líquen plano oral (LPO). O grupo de estudo compreendeu pacientes com diagnóstico clínico e histopatológico de LPO, segundo critérios da Organização Mundial de Saúde (WHO, 1978), com ou sem envolvimento cutâneo ou de outras mucosas. Um grupo controle composto por indivíduos sem lesão de líquen plano cutâneo e/ou mucoso, com perfil semelhante ao dos pacientes com LPO em relação ao sexo, idade e cor, foi incluído. Para avaliação de transtornos de ansiedade e depressão foram aplicadas duas escalas de auto-avaliação, respectivamente, o Inventário de Ansiedade Traço-Estado (IDATE-T) e a Escala de Rastreamento Populacional para Depressão - Center for Epidemiologic Studies Depression Scale (CES-D), ambas as escalas validadas internacionalmente. O uso diário de medicamentos foi analisado de acordo com os seguintes critérios: (1) classificação de medicamentos de acordo com o código ATC (Anatomical Therapeutic Chemical - classificação pela OMS, versão 2007), (2) quantidade de medicamentos utilizados - monofarmacia: 1 medicamento, polifarmacia menor: 2 a 4 medicamentos, e polifarmacia maior: 5 ou mais medicamentos, e (3) uso de medicamentos com potencial de induzir reação liquenóide a drogas. Sessenta e três pacientes LPO (média de idade = 54,2 anos, relação mulher/homem 6:1) e 35 do grupo controle (média de idade = 53,3 anos, relação mulher/homem 4:1) compuseram a casuística de pacientes avaliados. Os resultados demonstraram que não houve diferenças estatisticamente significantes (P > 0,05) entre o grupo LPO e o grupo controle com relação aos transtornos de ansiedade e depressão e o uso de medicamentos. Em conclusão, transtornos de ansiedade e depressão e o uso de medicamentos parecem não constituir fatores diretos na etiopatogenia do LPO. Todavia, esses fatores devem ser considerados na avaliação geral do paciente LPO, principalmente em termos de tratamento da lesão oral.
This study was aimed at investigating the possible association of the anxiety and depression disorders and the use of drugs with the oral lichen planus (OLP). The study group included patients with clinical and histopathologic diagnosis of OLP, according World Health Organization criteria (WHO, 1978), with or without skin and others mucosal involvement. A control group composed of individuals without skin and/or mucosal lichen planus, with similar characteristics to the OLP patients in respect to the sex, age and skin color, was included. For evaluation of anxiety and depression disorders a two self-administered scale the State-Trait Anxiety Inventory (STAI-T) and the Center for Epidemiologic Studies Depression Scale (CES-D) scales were applied, both internationally validated scales. The daily drug intake was analyzed according to the following criteria: (1) classification of drugs according the ATC code (Anatomical Therapeutic Chemical - classification by OMS, 2007 version), (2) amount of drugs used - monopharmacy: 1 drug, minor polipharmacy: 2 a 4 drugs, e major polipharmacy: 5 or more drugs, and (3) use of drugs with potential to induce a lichenoid drug reaction. Sixty-three patients (mean age = 54.4 years, ratio female/male = 6:1) and 35 individuals of control group (mean age = 53.3 years, ratio female/male = 4:1) composed the sample of patients evaluated. The results showed that there were no statistically significant differences (P> 0.05) between the OLP group and the control group with respect to anxiety and depression and the use of drugs. In conclusion, anxiety and depression disorders and the use of drugs seem to play no direct role in the etiopathogenesis of OLP. However, these factors should be considered for general evaluation of OLP patients, mainly for therapeutic purposes.

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2017-10-19T18:36:13Z No. of bitstreams: 1 PDF - Tomás Lúcio Marques de Almeida Lima.pdf: 17490044 bytes, checksum: 1d9051dcf6e9a941cad0b3dfa72def37 (MD5)
Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2017-10-26T16:06:16Z (GMT) No. of bitstreams: 1 PDF - Tomás Lúcio Marques de Almeida Lima.pdf: 17490044 bytes, checksum: 1d9051dcf6e9a941cad0b3dfa72def37 (MD5)
Made available in DSpace on 2017-10-26T16:06:16Z (GMT). No. of bitstreams: 1 PDF - Tomás Lúcio Marques de Almeida Lima.pdf: 17490044 bytes, checksum: 1d9051dcf6e9a941cad0b3dfa72def37 (MD5) Previous issue date: 2017-06-20
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Introduction: Anxiety for dentists and dental treatments can be understood as a response to situations where a source of threat to an individual is not well defined, can present itself in an ambiguous way, the subject might not necessarily be presented and associated with previous experiences considered traumatic. Dental fear, on the other hand, is a primary emotion that can trigger serious reflexes in adulthood, prompting individuals to avoid subsequent dental treatments. Objective: To verify the association between a traumatic dental experience, other sociodemographic criteria and dental anxiety among undergraduate students of a public institution of higher education. Materials and Methods: This was a cross-sectional, observational and analytical study. It was held at State University of Paraíba, with the participation of 633 students from four different courses: Dentistry, Mathematics, Pedagogy and Psychology. Modified Dental Anxiety Scale - MDAS (to assess dental anxiety), as well as considerations sociodemographic resources. Data analysis was performed using descriptive statistical for the evaluation of traumatic odontological experience and techniques and multivariate statistics through the analysis of structural equations. Results: Most of the students were female (71.4%), and 41% of the total participants reported experiencing traumatic dental experience, being performed mainly in 6-10 years (33.8%) and 11-15 years (27%). The statistical model of structural equation revealed reliability in the parameters of assessment of dental anxiety by the MDAS instrument (Estimates 0.777 - 0.898; p <0.001) in the sample of participants. The model also evaluated the direct influences of the interest variables on anxiety and higher occurrence of traumatic dental experiences. Women (p = 0.001), studying on other non-dental courses (p <0.001), who reported traumatic dental experiences (p <0.001) has shown higher occurrence of traumatic dental experiences. Individuals with more advanced age has shown higher occurrence of traumatic dental experiences as well (p <0.001). Also, indirect influence of age, when mediated by the occurrence of traumatic odontological experiences on dental anxiety indexes was observed (p < 0.001). Conclusion: The analyzes suggest a relation of association where women, undergraduate of courses other than Dentistry and with a history of previous traumatic dental experiences are more likely to exhibit higher levels of dental anxiety. In addition, older individuals are more likely to report traumatic odontological experiences and age, even without showing direct influence on anxiety levels, exhibits a significant indirect effect when mediated by the occurrence of traumatic dental experiences on levels of dental anxiety.
A ansiedade frente ao Cirurgião-dentista e aos tratamentos odontológicos, denominada ansiedade odontológica, pode ser compreendida como uma resposta a situações nas quais a fonte de ameaça ao indivíduo não está bem definida, pode apresentar -se de forma ambígua, não necessariamente encontra-se presente diante do sujeito e estar associada a experiências prévias consideradas traumáticas. O medo odontológico, por outro lado, é uma emoção primária que pode desencadear graves reflexos na idade adulta, levando os indivíduos a evitarem tratamentos odontológicos subsequentes. Objetivo: Verificar associação entre a presença de experiência odontológica traumática, outros fatores sociodemográficos e a ansiedade odontológica em alunos de graduação de instituição pública de ensino superior. Materiais e Métodos: Tratou-se de um estudo transversal, observacional e analítico. Foi realizado em uma instituição de ensino superior pública brasileira, a Universidade Estadual da Paraíba, com a participação de 633 estudantes de quatro cursos distintos: Odontologia, Matemática, Pedagogia e Psicologia. Os participantes preencheram um questionário autoexplicativo contendo o instrumento Modified Dental Anxiety Scale – MDAS (para avaliar a ansiedade odontológica), além de questões para constatação de experiência odontológica traumática e fatores sociodemográficos. A análise dos dados foi realizada por meio de técnicas estatísticas descritiva e multivariada por meio da análise de equações estruturais. Resultados: A maioria dos estudantes foi do gênero feminino (71,4%), onde 41% do total dos participantes relataram ter vivenciado experiência odontológica traumática, as quais ocorreram principalmente nas faixas etárias de 6-10 anos (33,8%) e 11-15 anos (27%). O modelo estatístico de equação estrutural revelou confiabilidade nos parâmetros de a ferição da ansiedade odontológica pelo instrumento MDAS (Estimativas 0,777 – 0,898; p < 0,001) na amostra dos participantes. O modelo também avaliou as influências diretas das variáveis de interesse sobre a ansiedade e a maior ocorrência de experiências odontológicas traumáticas. Indivíduos do sexo feminino (p = 0,001), estudantes dos cursos das demais grandes áreas que não a Odontologia (p < 0,001) e estudantes que relataram experiências odontológicas traumáticas (p < 0,001) exibiram escores maiores de ansiedade, assim como a ocorrência de experiências odontológicas traumáticas foi maior em indivíduos com idade mais avançada (p < 0,001). Outrossim, constatou-se influência indireta da idade, quando mediadas pela ocorrência de experiências odontológicas traumáticas, sobre os índices de ansiedade odontológica (p < 0,001). Conclusão: As análises sugerem uma relação de associação onde mulheres, graduandas de outros cursos que não a Odontologia e com histórico de experiências odontológicas traumáticas prévias estão mais propensas a exibirem níveis mais altos de ansiedade odontológica. Além disso, indivíduos com idade mais avançada foram mais propensos a relatarem experiências odontológicas traumáticas e a idade, mesmo não demonstrando exercer influência direta nos níveis de ansiedade, exibiu um efeito indireto significativo quando mediada pela ocorrência de experiências odontológicas traumáticas sobre o nível de ansiedade odontológica.

Premenstrual depressive symptoms and mood swings affect 3-8% of women in fertile age. The female hormones are believed to be the cause. Progesterone is well studied, but estrogen is not, and either are other causes such as intimate partner violence and chronic stress. The aim in this thesis was to investigate the influence of hormones as well as psychological aspects on the most common problems among women seeking care for premenstrual symptoms. In a cross-sectional study, four groups of women were included: ongoing users of oral contraceptives, with or without adverse mood symptoms and previous users, with or without experience of adverse mood. Depression and anxiety were significantly more common in both groups with reported adverse mood, in comparison with their control groups with no adverse mood. Self-reported PMS was significantly more common in those women who reported adverse mood, however, there was no difference in prospectively defined PMS or PMDD between the two groups of previous users. In a RCT with 25 women completing the study, GnRH treatment were tested in combination with two different HRT add-back doses of estradiol, in combination with progesterone and placebo. The higher dose of estrogen 1.5 mg in combination with progesterone induced significantly more pronounced symptoms than in combination with placebo. The lower dose, 0.5 mg gave less symptom recurrence in combination with progesterone. Exposure to violence was investigated among PMDD patients, healthy controls and gynecological patients. Among the participating women, gynecological patients, reported physical and/or emotional abuse significantly more often than did PMDD patients, as well as healthy controls. Chronic stress was investigated with diurnal cortisol, and low-dose dexamethasone test.  There was no difference in diurnal secretion of cortisol between PMDD patients and controls. No difference in the degree of dexamethasone suppression was found between PMDD patients and controls. According to the results from these studies, the main symptom provoking factor in women with PMDD appears to be the estradiol and progesterone fluctuations across the menstrual cycle, whereas chronic stress and intimate partner violence appears to be less relevant.

碩士
高雄醫學大學
公共衛生學系公共衛生學碩士班
103
Background Approximately 600 million people worldwide regularly chew betel-quid(BQ), and 10% of the Taiwanese use it. Arecoline has a chemical structure comparable to nicotine. In animal experimental studies, also found that its have the effect of antidepressant. Despite the understanding of pharmacological reactions for BQ, little is known about the the relationship between the addiction of BQ chewing and anxiety, depression and oral potentially malignant disorders (OPMD). Purpose To investigate the factors that are associated with addictive use of BQ among chewers, and the relationship between BQ addiction and anxiety, depress and oral potentially malignant disorders. Material and methods To investigate these issues, we conducted a community-based cross-sectional study using probability proportionate to size sampling to recruit participants. All participants were recruited from Taiwan Kaohsiung city. All chewers were evaluated for BQ addiction using the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) criteria, anxiety was measured using the Beck Anxiety Inventory (BAI), and depress was using Center for Epidemiologic Studies Depression Scale (CES-D). Results A total of 250 BQ chewers and 156 non-chewers recruited from 123 BQ shops and 59 convenience stores in Kaohsiung city, respectively. According to DSM-IV and DSM-V, the chewers who had BQ addiction were more likely to be male, be married, have low educational level, low income, and work as a laborer. A five-BQ increase in the amount consumed , a one-day increase in the use, a one-year younger at starting age, and swallowed BQ juice were associated with a 1.01-1.03, 1.3-1.5, 1.02-1.1 and 2.2-2.9-fold significant risk of contracting BQ addiction, respectively. As compared to non-addictive chewers, addictive chewers had a higher anxiety (aOR=2.1). No BQ dependence/addiction chewers in minimal level of anxiety is lower than non-chewers (aOR=0.4-0.5). As compared to non-addiction chewers, addiction chewers had 3.7-fold risk of OPMD. Conclusions This study found that BQ addiction chewers are associated with lower socioeconomic status, and substance use characteristics. Addictive BQ use is positively related to amounts, days, years of chewing and swallowed BQ juice, and negatively related to starting age. Non-chewers had higher anxiety than non dependence/addiction chewers. Addictive chewers had high risk in minimal level of anxiety and OPMD.

Introduction : Les dysfonctions et désordres temporo-mandibulaires (DTM) sont un groupe de conditions pathologiques et dysfonctionnelles affectant les articulations temporo-mandibulaires, les muscles masticateurs et les tissus contigus. Les DTM ont une origine multifactorielle, impliquant des facteurs de risque comportementaux, psychosociaux, génétiques et orthodontiques. Objectifs : Le but de cette recherche est de déterminer la prévalence des DTM et de leurs possibles associations aux parafonctions orales dans une population orthodontique, et d’autre part, par une éducation thérapeutique simple (exposé oral avec illustrations et courtes vidéos), de faire prendre conscience de ces mauvaises habitudes aux patients. Matériels et méthodes: Dans un échantillon de candidats au traitement orthodontique (n=101, âge moyen 15,4±5,6 ans), nous avons dépisté les habitudes orales, les DTM et l'anxiété à l'aide de la liste des habitudes orales (OBC), des critères de diagnostic pour les DTM (RDC/DTM) et du questionnaire GAD-7. Une conférence de prévention de 10 minutes a suivi, en petits groupes. Après 2 mois, les patients ont reçu de nouveaux questionnaires OBC et RDC/ DTM via une enquête par e-mail. Résultats: Les symptômes de DTM ont affecté 21% des sujets, tandis que 10% ont montré une anxiété modérée à sévère (GAD7≥ 10), avec des scores plus élevés chez les femmes (p<0,05). Les symptômes n'étaient pas liés à des malocclusions mais étaient positivement corrélés avec l'anxiété et les habitudes orales, en particulier celles augmentant la fonction des muscles masticateurs. La session éducative a été appréciée par 97,1% des personnes ayant répondu à l'enquête (66/68). Une réduction significative de l’OBC a été trouvée chez les sujets anxieux après 2 mois (GAD7≥5, n=14): ils avaient réduit leur utilisation de gomme à mâcher mais ont rapporté parallèlement une augmentation du bruxisme et des contractions des muscles masticateurs. Aucun changement significatif ne s'est produit dans les scores OBC ou DTM chez les sujets à anxiété minimale (GAD7<5, n=46), qui avaient des symptômes et des parafonctions minimales au départ par rapport aux sujets anxieux (DTM de 1,4±1,7 contre 0,6±1,0 p<0,05 et OBC de 20,0±12,1 contre 36,4 ±11,0 p<0,05). Conclusions: Les troubles anxieux devraient être dépistés chez les patients orthodontiques, en association avec une éducation préventive sur les habitudes orales, car tous deux ont une relation forte avec les DTM. Le bruxisme et les mouvements des muscles masticateurs associés pourraient nécessiter un soutien spécifique supplémentaire.
Introduction: Temporomandibular disorders (TMD) are a group of pathologic and dysfunctional conditions affecting the temporomandibular joints, masticatory muscles and contiguous tissues. TMD have a multifactorial origin, involving behavioral, psychosocial, genetic and orthodontic risk factors. Objectives: The aim of this research was to determine the prevalence of TMDs and their possible associations with oral parafunctions in an orthodontic population, and on the other hand, by a simple therapeutic education (oral presentation with illustrations and short videos), to make patients aware of these bad habits. Materials and methods: In a sample of orthodontic treatment candidates (n=101, mean age 15.4± 5.6 years-old), we screened for oral habits, TMD and anxiety using the Oral Behavior Checklist (OBC), Diagnostic Criteria for TMD (RDC/TMD) and GAD7 questionnaires. A 10 minutes prevention conference followed, in small groups. After 2 months, patients received new OBC and RDC/TMD questionnaires via an email survey. Results: TMD symptoms affected 21% of subjects, whereas 10% showed moderate to severe anxiety (GAD7≥10), with higher scores in females (p<0.05). Symptoms were not related to malocclusions but were positively correlated with anxiety and oral habits, especially those increasing masticatory muscles function. The educational session was appreciated by 97.1% who completed the survey (66/68). Significant reduction in OBC was found in anxious patents after 2 months (GAD7≥5, n=14): they had reduced their chewing-gum use but selfreported increased bruxism and clenching in the meantime. No significant change occurred in neither OBC nor TMD scores in the minimally anxious subjects (GAD7<5, n=46), whom had baseline minimal symptoms and habits compared to anxious subjects (TMD score 1.4±1.7 versus 0.6±1.0, p<0.05 and OBC score 20.0±12.1 versus 36.4 ±110 p<0.001). Conclusion: Anxiety disorders should be screened in orthodontic patients, in association with preventive education on oral habits, as both have a strong relation with TMD. Bruxism and related masticatory muscles movements might require additional specific support.

Hashimoto's encephalopathy is a relapsing encephalopathy occurring in association with Hashimoto's thyroiditis (HT) with high titers of anti-thyroid antibodies. The mechanism of pathogenesis is unknown. Auto-antibodies to α-enolase have been found to be associated with Hashimoto's encephalopathy. Recently, the crucial role of neuro-inflammation in the development of psychological disorders including depression and anxiety has received more attention. Because the majority of patients with Hashimoto's encephalopathy respond to steroids or immuno-suppressant treatment, this condition is now also referred to as “steroid-responsive encephalopathy.” Initial treatment is usually with oral prednisone (50–150 mg/day) or high-dose IV methyl-Prednisolone (1 g/day) for 3-7 days. Thyroid hormone treatment is also included if required. This chapter explores Hashimoto's encephalopathy.