title: Association of periodontal disease to anxiety and depression symptoms, and psychosocial stress factors.
abstract: OBJECTIVE
  A cross-sectional study was conducted to investigate if anxiety, depression and hopelessness symptoms are associated with periodontal disease.
  
  
  METHODS
  A total of 160 subjects took part in this study. Probing depth and clinical attachment level were recorded at six sites per tooth and the gingival and plaque indices were also recorded. The instruments used to assess the psychological variables (anxiety, depression, stress, psychiatric symptoms and hopelessness) were: the State-Trait Anxiety Inventory, the Beck Depression Inventory, the Life Events Scale modified by Savoia, the Self-Report Screening Questionnaire-20 and the Beck Hopelessness Scale.
  
  
  RESULTS
  There was no difference in scale score means between patients with and without established periodontitis. Results of the Ordinal Logistic Regression Analysis model that included age, plaque index, smoking and psychological factors showed that patients with psychiatric symptoms (odds ratio (OR) 1.24, 95% confidence interval (CI) 0.33-4.78), depression symptoms (OR 0.57, 95% CI 0.15-2.21) and with hopelessness (OR 0.70, 95% CI 0.13-3.84) were not at a greater risk of developing established periodontitis.
  
  
  CONCLUSIONS
  In this sample, no evidence was found for an association between depression, hopelessness, psychiatric symptoms and established periodontitis. The association of periodontal disease to depression, anxiety and stress should be investigated in psychiatric populations, especially in those with depression and anxiety disorders.
authors.affiliation: Department of Periodontology, University of São Paulo, São Paulo, Brazil. anacristinasolis@hotmail.com
authors.forename: A C O
authors.initials: AC
authors.lastname: Solis
authors.forename: R F M
authors.initials: RF
authors.lastname: Lotufo
authors.forename: C M
authors.initials: CM
authors.lastname: Pannuti
authors.forename: E C
authors.initials: EC
authors.lastname: Brunheiro
authors.forename: A H
authors.initials: AH
authors.lastname: Marques
authors.forename: F
authors.initials: F
authors.lastname: Lotufo-Neto
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000523:psychology*; D010512:Periodontal Index; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000523:psychology*