title: Severity of illness and extra pyramidal symptoms as predictors for oral diseases among patients with schizophrenia.
abstract: OBJECTIVE
  The study explores the association between severity of illness (positive, negative, depressive and cognitive symptoms) and extra pyramidal symptoms (EPS) with dental caries, periodontal disease and prosthetic needs among patients with schizophrenia.
  
  
  METHODS
  A total of 71 schizophrenic patients diagnosed based on ICD-10 criteria participated in the study. Clinical Global Impression - Schizophrenia (CGI-SCH) scale was used to evaluate positive, negative, depressive, cognitive symptoms and overall severity of schizophrenia. Simpson-Angus Scale (SAS) was used for assessment of EPS. Dental examinations were conducted as per WHO (1997) criterion.
  
  
  RESULTS
  Mean DMFT and CPI scores with periodontal pockets were 5.57 ± 2.12 and 2.37 ± 0.74; significant differences being noted among those with and without EPS (p < 0.001). Positive and EPS associated with dental caries with odds ratio of 5.26 (1.05, 26.2) and 8.52 (2.31, 31.4) (p < 0.001). Depressive and EPS were associated with periodontal disease with odds ratio of 4.19 (1.53, 32.5) and 5.27 (1.29, 21.5), respectively (p < 0.001). Cognitive and EPS were associated with dental prosthetic needs with odds ratio of 4.33 (1.47, 31.2) (p < 0.001) and 7.78 (1.43, 42.2), respectively (p < 0.001).
  
  
  CONCLUSIONS
  Patients with schizophrenia had high dental caries, periodontal disease and unmet dental prosthetic needs. Severity of the schizophrenic and EPS was associated with poor oral health. Efforts need to be focused on strengthening the evidence of its association with oral health indicators through further studies including cohort investigations.
authors.affiliation: a Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Ministry of Health and Family Welfare, Government of India, Bhopal, India.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Singh
authors.affiliation: b Department of Psychiatry , All India Institute of Medical Sciences (AIIMS), Ministry of Health and Family Welfare, Government of India , Bhopal , India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Mittal
authors.affiliation: a Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Ministry of Health and Family Welfare, Government of India, Bhopal, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Goel
authors.affiliation: c Department of Public Health Dentistry , Peoples College of Dental Sciences and Research Centre , Bhopal , India.
authors.forename: Bharathi M
authors.initials: BM
authors.lastname: Purohit
authors.affiliation: a Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Ministry of Health and Family Welfare, Government of India, Bhopal, India.
authors.forename: Rishi
authors.initials: R
authors.lastname: Thukral
mesh_terms: D000328:Adult; D003729:Dental Care / Q000706:statistics & numerical data; D003731:Dental Caries / Q000175:diagnosis / Q000209:etiology*; D005116:Extrapyramidal Tracts / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000706:statistics & numerical data*; D010510:Periodontal Diseases / Q000175:diagnosis / Q000209:etiology*; D012559:Schizophrenia / Q000150:complications*; D012720:Severity of Illness Index
keywords: Cognitive disorders; depressive symptoms; extra pyramidal disorders; oral health; schizophrenia