Associations between oral health and depression and anxiety: A cross-sectional and prospective cohort study from the UK Biobank

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Clinical Periodontology Pub Date : 2024-07-01 DOI:10.1111/jcpe.14039

Jingjing Wang, Yani Wang, Huihui Li, Weijing Wang, Dongfeng Zhang

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Abstract

Aim

To investigate the associations between oral health and depression, anxiety and their comorbidity in the UK Biobank cohort.

Materials and Methods

Oral health problems were self-reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ-4) in a cross-sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety.

Results

A total of 305,188 participants were included in the cross-sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73–1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10–1.19), depression (HR: 1.19, 95% CI: 1.13–1.25) and anxiety (HR: 1.13, 95% CI: 1.07–1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16–1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C-reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow-up (N = 10,673) were not significant.

Conclusions

Periodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity.

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口腔健康与抑郁和焦虑之间的关系：来自英国生物库的一项横断面和前瞻性队列研究。

目的：调查英国生物库队列中口腔健康与抑郁、焦虑及其合并症之间的关系：基线时自我报告口腔健康问题。在横断面研究中，使用心理健康问卷（PHQ-4）评估抑郁和焦虑症状。在队列研究中，抑郁症和焦虑症的诊断以医院记录为依据。研究采用逻辑回归和考克斯回归模型分析口腔健康与抑郁/焦虑之间的关系：多变量分析表明，牙周病与抑郁和/或焦虑相关（几率比 [OR]：1.79，95% 置信区间 [CI]：1.73-1.86）。在涉及 264 706 名参与者的前瞻性队列研究中，牙周病与抑郁和/或焦虑（危险比 [HR]：1.14，95% 置信区间 [CI]：1.10-1.19）、抑郁（HR：1.19，95% 置信区间 [CI]：1.13-1.25）和焦虑（HR：1.13，95% 置信区间 [CI]：1.07-1.19）的风险增加显著相关。牙周病与合并抑郁和焦虑也有明显关联（HR：1.27，95% CI：1.16-1.38）。利用基线炎症因子进行的多重中介分析表明，白细胞计数和 C 反应蛋白分别解释了牙周病与抑郁和焦虑之间 3.07% 和 3.15% 的关联。然而，对首次随访时的炎症因子（N = 10 673）进行纵向多重中介分析的结果并不显著：结论：研究发现，牙周病与抑郁症、焦虑症及其并发症的风险增加一直存在关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.