Psychometric analysis of stress, anxiety and depression in patients with recurrent aphthous Stomatitis-A cross-sectional survey based study

Abstract

Background: Recurrent Aphthous Stomatitis is a chronic inflammatory immune mediated condition associated with single or multiple, painful recurring ulcers of the oral mucosa. Psychological stress is a common trigger factor identified for the onset and progression of this condition. The study aimed to evaluate stress, anxiety and depression using the Hospital Anxiety and Depression scale and stress by the General Health Questionnaire in subjects with Recurrent Aphthous Stomatitis (RAS). Material and Methods: The study evaluated subjects with a history of Recurrent Aphthous Stomatitis and compared their psychological stress, anxiety and depression alteration to normal subjects. Seventy-five study subjects were divided into three groups; test group 1 (25 subjects) presenting with RAS, test group 2 (25 subjects) with a history of RAS but without oral ulcers, and 25 normal subjects with no history of RAS formed the control group. Chi square and student t test was used to determine the relationship between psychological variables and recurrent aphthous ulcers. Results: Comparison of stress, Anxiety and Depression between test group 1 and control group, test group 2 and control group was not found to be statistically significant (p < 0.05). Hence, differences were evident when individual questions were analyzed for stress anxiety and depression. Stress and depression were more prevalent in females, students and patients with a history of RAS. Conclusions: Higher depression and stress levels were evident in subjects with a history of RAS. Psychological stress is a utmost trigger factor for the initiation of recurrent ulcers. Overall, test group patients had a more psychological impact on the quality of life than the control group.