title: Stress associated with onset of recurrent aphthous stomatitis.
abstract: METHODS
  Randomised controlled trial (RCT).
  
  
  METHODS
  One hundred and sixty patients participating in a RCT in which they were randomised to multivitamins (n=81) or placebo (n=79) completed ulcer diaries and a weekly telephone survey by calling an automated interactive voice response (IVR) system. Stressful events were quantified using the validated Recent Life Changes Questionnaire (RLCQ) and were classified as mental or physical stressors.
  
  
  METHODS
  Onset and duration of RAS episodes
  
  
  RESULTS
  Stressful life events were significantly associated with the onset of RAS episodes (P < 0.001), but not with the duration of the RAS episodes. Experiencing a stressful life event increased the odds of an RAS episode by almost three times (OR = 2.72; 95% CI = 2.04-3.62). When controlled for each other, mental stressors had a larger effect (OR = 3.46, 95% CI = 2.54- 4.72) than physical stressors (OR = 1.44; 95% CI = 1.04- 1.99) on the occurrence of RAS episodes. RAS episodes did not occur more frequently or last longer with increasing stress severity.
  
  
  CONCLUSIONS
  In patients with a history of RAS, stressful events may mediate changes involved in the initiation of new RAS episodes. Mental stressors are more strongly associated with RAS episodes than physical stressors.
authors.affiliation: NYU College of Dentistry, New York, USA.
authors.forename: Analia Veitz
authors.initials: AV
authors.lastname: Keenan
authors.forename: Silvia
authors.initials: S
authors.lastname: Spivakovksy