title: Evaluation of Xerostomia in Different Psychological Disorders: An Observational Study.
abstract: BACKGROUND
  Psychiatric diseases like anxiety, depression, schizophrenia and bipolar disorders are increasing at an alarming rate. These diseases can affect the quantity and quality of saliva leading to multiple oral diseases. Although many researchers have evaluated xerostomia in general population, its prevalence is not been assessed in patients suffering from different psychological disorders.
  
  
  OBJECTIVE
  To investigate the prevalence of xerostomia and to assess the correlation between xerostomia and dryness of lip and mucosa in different psychological disorders.
  
  
  METHODS
  A cross-sectional observational study was conducted over a period of six months in Department of Psychiatry and Department of Oral Medicine. Patients with anxiety, depression, schizophrenia and bipolar disorder, as diagnosed by an experienced psychiatrist, were given a questionnaire to evaluate the xerostomia. Patients with symptoms of xerostomia were subjected to oral examination by a skilled oral diagnostician to check for dryness of lips and mucosa. One hundred patients from each group of psychiatric diseases were included in the study using a consecutive sampling technique. An equal number of healthy individuals reporting to oral medicine department for routine oral screening were included as control group after initial psychiatric evaluation.
  
  
  RESULTS
  In this study statistically significant increase in the xerostomia in psychiatric patients was recorded when compared to the control group (p<0.01). Xerostomia was significantly higher in anxiety patients (51%) followed by depression (47%), bipolar disorder (41%), schizophrenia (39%) and control group (27%). The majority of the psychiatric patients had 'moderate' to 'severe' xerostomia whereas the control group had 'mild' xerostomia. Xerostomia was significantly higher in younger age group (18-49 years) than in older age group and females patients had higher xerostomia than male patients. Psychiatric patients had significantly more dryness of lip and mucosa than healthy controls. A moderate to strong spearman correlation (r=0.72) was observed between xerostomia and psychological alterations.
  
  
  CONCLUSIONS
  A positive association was established between psychological alterations and xerostomia and dryness of lip and mucosa. Emotional alterations may act as a precipitating factor that could influence the salivary secretion resulting in multiple oral diseases. Psychiatrists can screen for xerostomia and collaborate with dentists for comprehensive management of xerostomia in psychiatric patients.
authors: Lecturer, SEGi University , No. 9, Jalan Teknologi, Taman Sains, Petaling Jaya, Kota Damansara, Selangor - 47810, Malaysia .
authors: Suresh Kandagal
authors: SK
authors: Veerabhadrappa
authors: Senior Lecturer, Department of Oral Pathology and Microbiology, College of Dental Sciences , Davangere, Karnataka, India .
authors: Pramod Redder
authors: PR
authors: Chandrappa
authors: Assistant Professor, Department of Public Health Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University , Karad, Satara, Maharashtra, India .
authors: Snehal
authors: S
authors: Patil
authors: Post graduate student, Department of Periodontology, Mahatma Gandhi Mission's Dental College and Hospital , Sector 1, Kamothe, Navi Mumbai, Maharashtra, India .
authors: Seema Yadav
authors: SY
authors: Roodmal
authors: Interim Chair Division of Periodontics, East Carolina University School of Dental Medicine , 1851 Macgregor Downs Rd, Mail Stop 701, Greenville NC 27834, USA .
authors: Akshay
authors: A
authors: Kumarswamy
authors: Reader, Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University , Karad, Satara, Maharashtra, India .
authors: Mounesh Kumar
authors: MK
authors: Chappi
keywords: Anxiety; Bipolar disorder; Depression; Psychosomatic diseases; Saliva; Schizophrenia