Digital imaging of patterns of dental wear to diagnose bruxism in children

OBJECTIVE

The aim of this study was to evaluate and compare the area, perimeter, and form (D factor and fractal dimension) of the dental wear among bruxist and nonbruxist children with mixed dentition in order to determine if the dental wear may be used as criteria to diagnose bruxism.

METHODS

The children were 8 to 11 years old and were classified as bruxist or nonbruxist, according to anxiety level and temporomandibular disorders. Dental casts of the upper arch were obtained for the bruxist (n = 24) and the control (n = 29) group. The dental wear was measured in digital format and processed automatically. The complete and pathological dental wear was compared between the two groups, using the Student's t-test and Mann-Whitney test.

RESULTS

Statistically significant differences were observed between the two groups, with a higher area, perimeter, and more irregular form of the pathological dental wear among the bruxist group. Regarding complete dental wear, differences were only significant for the D factor (an un-dimensional quantitative parameter which produces a relation between the area and the perimeter of an object).

CONCLUSION

Digital imaging of dental wear may be used as criteria to diagnose bruxism in children with mixed dentition after making an analysis of the area, perimeter, and irregularity of the form of pathological dental wear.

[Types of anxiety reported by couples treated with assisted fertilization vis a vis hypothethical embryo donation for research purposes in a private clinic in Lima, Peru]

INTRODUCTION

Embryo donation displays special characteristics within the Latin American context, where spare cryopreserved embryos are not currently available as is the case of industrialized countries. The Catholic church also plays a significant role. The need to regulate ethically and legally the practice of embryo donation suggests that we need to take into account the opinions from the main key players: patients, health professionals, and society. The objective of this study is to explore the patients perceptions vis a vis potential embryo donation for research purposes.

MATERIALS AND METHODS

A descriptive, cross-sectional design included a tape recorded semi-structured interview administered to 32 patients attending a private clinic in Lima, Peru. Participants had undergone complex techniques of assisted fertilization (FIV and ICSI). The verbal Gottschalk analytical method was used to identify predominant anxiety manifestations in the interviews.

RESULTS

The most common types of anxiety associated with embryo donation for research in this group of participants were guilt, separation anxiety and shame. Divided by gender, the more common types of anxiety reported by men were guilt, shame and separation anxiety. Women reported guilt, separation anxiety and shame.

Symptoms of depression and anxiety in relation to dental health behavior and self-perceived dental treatment need

The purpose of this study was to investigate the dental health behavior and self-perceived dental treatment need, in relation to depressive symptoms and symptoms of anxiety, among a general population drawn from a sample of 31-yr-old-men and women born in Northern Finland in 1966 (n = 8463). The dental health behavior included toothbrushing frequency and the frequency of dental check-ups. Depressive symptoms, as well as symptoms of anxiety, were determined on the basis of the Symptom Checklist-25 (SCL-25). The participants were also asked about their education and family income. Subjects with a high number of depressive symptoms had lower toothbrushing frequency as well as a lower frequency of dental visits than subjects with no or only a few depressive symptoms. Morover, the self-perceived dental treatment need was more common among those with a high number of depressive symptoms. Symptoms of anxiety were significantly associated with lower toothbrushing frequency. The results support the view that there is an increased risk for impaired dental health among subjects with depressive symptoms or symptoms of anxiety.

Association between psychosocial factors and periodontitis: a case-control study

OBJECTIVE

This case-control study investigated the association between life events, anxiety, and depression with periodontitis.

METHODOLOGY

The study counted with 165 individuals, both sexes, 35-60 years of age. Case group included 96 individuals suffering from periodontal disease; and in control group 69 subjects with no history of periodontitis. Clinical examinations were performed by a single examiner. Psychological assessment included four inventories: Life Events Scale, Beck Anxiety Inventory, State-Trait Anxiety Inventory and Beck Depression Inventory. Bivariate and multivariate logistic regression analyses were performed to compare cases and controls.

RESULTS

Mean probing depth and clinical attachment level were 3.44+/-0.80 and 4.01+/-1.61 in the case group and 1.96+/-0.19 and 0.95+/-0.50 in the control group, respectively (p<0.05). Positive association of periodontitis with age (odds ratio (OR)=1.15 95% confidence interval (CI): 1.06-1.24), male gender (OR=2.71, CI: 1.13-6.49), smoking (OR=6.05, CI: 1.67-21.94) and educational level (OR=6.49, CI: 1.14-36.95) was confirmed. Bivariate analysis did not demonstrate significant mean differences in life events, anxiety symptoms, trait or state of anxiety, or depression symptoms between cases and controls. Multivariate logistic regression, controlling for confounding factors, demonstrated no significant association between psychosocial factors and periodontal disease.

CONCLUSIONS

Within the limits of this study it is possible to conclude that there was no significant association between periodontitis and the psychosocial factors analysed.

[Identification of types in small samples with the help of bootstrap simulation (illustrated with the help of the anxiety/depression subscales of the HAD)]

Using a HAD-file as an illustration, we could show that small files (n = 50) can provide statistically significant results if we apply bootstrap simulation. First the subscales "anxiety" and "depression" are computed and afterwards classified (in three categories). Both classified subscales are cross tabled and submitted to a configurational cluster analysis. One type can be clearly identified. To test the stability of the one-type solution, a bootstrap simulation (Lautsch/von Weber: BOOTSTRAP) is applied. The simulation confirms the one-type solution.

[Socio-demographic identification of anxiety-depression types (socio-demographic specification and prediction of types)]

In the article "Identification of Types in Small Samples with the help of Bootstrap Simulation" we could show how anxiety-depression types could be explored in small samples. We used the two sub-scales (anxiety and depression) in accordance with the indications of the HAD manual of Zigmond, A.S. & Snaith R.P. . The extraction of types will be repeated with the data of n=168 homeless people. Then the socio-demographic homogeneity of the extracted types will be tested. With this procedure we want to answer the question, whether in the sub-group of homeless people, the knowledge the degree of expression of some significant socio-demographic traits will allow us assigning them to specific anxiety-depression types.

Identifying anxiety states using broad sampling and advanced processing of peripheral physiological information

Advances in biosignal acquisition and processing have provided an effective window to the complex peripheral physiology related to human emotions. Numerous cardiovascular measures have been used for assessing the activity of the sympathetic and parasympathetic branches of the autonomic nervous system. More recently, respiratory parameters have shown promise for the assessment of anxiety. Current theoretical accounts of anxiety recommend a broad assessment of anxiety responses involving measures from the physiological, behavioral and verbal-cognitive domain. However, practical and statistical considerations put restrictions on the number of dependent variables used in studies on emotion. In a laboratory experiment we assessed a large number of psychophysiological parameters to identify their relative utility for differentiating between a neutral (quiet sitting) and an anxious state induced by threat of shock. High effect sizes were found in all psychophysiological systems with electrodermal and behavioral responses demonstrating the highest, and respiratory and cardiovascular responses yielding medium and small effect sizes. A linear combination of the six most powerful variables was highly significant in distinguishing the neutral from the anxious state and resulted in 83.3% correct classification. Results demonstrate the necessity to include measures from multiple response domains for an adequate assessment of anxiety states. Furthermore, our results point to the significance of respiratory parameters in anxiety assessment.

Defining oppositional defiant disorder

BACKGROUND

ICD-10 and DSM-IV include similar criterial symptom lists for conduct disorder (CD) and oppositional defiant disorder (ODD), but while DSM-IV treats each list separately, ICD-10 considers them jointly. One consequence is that ICD-10 identifies a group of children with ODD subtype who do not receive a diagnosis under DSM-IV.

METHODS

We examined the characteristics of this group of children using the Great Smoky Mountains Study of children in the community aged 9-16. This study provided child and parent reports of symptoms and psychosocial impairment assessed with standardised diagnostic interviews.

RESULTS

Children who received an ICD-10 diagnosis but not a DSM-IV diagnosis showed broadly similar levels of psychiatric comorbidity, delinquent activity and psychosocial impairment to those who met DSM-IV criteria in both cross-sectional and longitudinal analyses.

CONCLUSIONS

These results indicate that DSM-IV excludes from diagnosis children who receive an ICD-10 diagnosis of CD (ODD sub-type), and who are substantially disturbed. Methods of redressing this situation are considered.

Intra-oral findings and general health conditions among institutionalized and non-institutionalized elderly in Greece

BACKGROUND

The aim of the study was to record the findings from intra-oral examination and the general health conditions encountered in a group of Greek individuals 65 years of age or older.

PATIENTS AND METHODS

The study subjects were derived from the elderly attending 12 randomly selected community centres located in Athens and neighbouring municipalities, consisting the non-institutionalized study group and from the elderly living in three ecclesiastical nursing homes, consisting the institutionalized study group. The research data comprised information from the subjects' interviews, self-defined health status, medical records and intra-oral examination on the following variables: sex, age, general health condition, dentate or not, use of dentures and oral conditions. Fisher's exact two-sided test was used for statistical analysis.

RESULTS

Overall, 316 patients were examined; 120 male (38%), 196 female (62%), mean age 78 years (range: 65-99). Of those, 150 were non-institutionalized (59 male, 91 female) and 166 institutionalized (61 male and 105 female). The vast majority (90%) of the patients had at least one general health problem, for which they were taking daily medication. Twenty-three different medical conditions were recorded. The most frequent medical problems were hypertension (56%), cardiovascular problems (41%), depression/anxiety (39%), arthritis (18.5%) and visual problems (16%). The vast majority of the study patients (79%) were edentulous, while 33% were not wearing or using their dentures. Almost half of them (47%) had at least one oral condition. Twenty-seven different oral conditions were recorded. The most frequent oral findings were denture-induced stomatitis (17.2%), dry mouth (14.6%), atrophy of tongue papillae (10.5%), fissured tongue (9.8%) and haemangioma (6.8%). No cases of malignant lesions were observed.

CONCLUSIONS

The present study confirms that in this particular age group, general health problems are frequent, variable, coexistent, necessitating the daily administration of multiple medications, while oral examination by a specialist is an essential part of the multidisciplinary medical care in this group of individuals.

Pharmacotherapy of anxiety

The pharmacological treatment of anxiety has a long and chequered history, and recent years have seen a rich development in the options available to prescribers. Most of the currently used anxiolytic agents act via monoaminergic (chiefly serotonin) or amino acid (GABA or glutamate) neurotransmitters, and this chapter describes the pharmacology of the major drug groups. Clinical applications are discussed with respect to the five major anxiety disorders, as well as simple phobia and depression with concomitant anxiety. Prospective future developments in the field are considered.

Taxonicity of anxiety sensitivity: an empirical test among youth

Taxometric coherent cut kinetic analyses were used to test the latent structure of anxiety sensitivity (AS) among 371 youth. Anxiety sensitivity was indexed by the 18-item Childhood Anxiety Sensitivity Index (CASI; Silverman et al., J. Clin. Child Psychol. (1991), 20, 162-168). Two sets of manifest indicators of AS were constructed using the CASI: (1) three item-parcel manifest indicators: disease concerns, unsteady concerns, and mental illness concerns; and (2) nine single-item indicators representing each of these three facets of AS. Results from standard and short-scale MAXCOV procedures, internal consistency tests, analyses of simulated Monte Carlo data, and MAMBAC external consistency tests indicated that the latent structure of anxiety sensitivity among youth was taxonic. Estimated base rate of the observed AS taxon ranged between 13.6 and 16.5%. The present findings are discussed in terms of theoretical implications for the study of AS and vulnerability for anxiety psychopathology.

Performance of the Faces Anxiety Scale in patients transferred from the ICU

Intensive Care Unit (ICU) patients are often not able to respond to long self-report instruments, therefore, in order to assess anxiety accurately, a short and easy to use measure is required. The Faces Anxiety Scale (FAS) developed by McKinley et al. [McKinley S, Coote K, Stein-Parbury J. Development and testing of a faces scale for the assessment of anxiety in critically ill patients. J Adv Nurs 2003;41(1):73-9.] has promised to be such an instrument. This study assessed the construct validity of the FAS against the well validated anxiety subscale of the Hospital Anxiety and Depression Scale (HADS), in an ICU population ready for transfer to the ward. The study was a part of a larger study of transfer anxiety. The FAS showed good correlation with the anxiety sub-scale of the HADS which strengthened over time. The FAS was easy and quick to use and seemed to measure anxiety in ICU patients that were ready to move to the wards, however, further testing in a larger sample and with sicker ICU patients is required.

Gastrointestinal symptoms in spinal cord injury: relationships with level of injury and psychologic factors

INTRODUCTION

Previous surveys of gastrointestinal symptoms after spinal cord injury have not used validated questionnaires and have not focused on the full spectrum of such symptoms and their relationship to factors, such as level of spinal cord injury and psychologic dysfunction. This study was designed to detail the spectrum and prevalence of gastrointestinal symptoms in spinal cord injury and to determine clinical and psychologic factors associated with such symptoms.

METHODS

Established spinal cord injury patients (>12 months) randomly selected from a spinal cord injury database completed the following three questionnaires: 1) Rome II Integrative Questionnaire, 2) Hospital Anxiety and Depression Scale, and 3) Burwood Bowel Dysfunction after spinal cord injury.

RESULTS

A total of 110 patients participated. The prevalence of abdominal bloating and constipation were 22 and 46 percent, respectively. Bloating was associated with cervical (odds ratio = 9.5) and lumbar (odds ratio = 12.1) level but not with thoracic level of injury. Constipation was associated with a higher level of injury (cervical odds ratio = 5.6 vs. lumbar) but not with psychologic factors. In contrast, abdominal pain (33 percent) and fecal incontinence (41 percent) were associated with higher levels of anxiety (odds ratio = 6.8, and odds ratio = 2.4) but not with the level of injury.

CONCLUSIONS

There is a high prevalence and wide spectrum of gastrointestinal symptoms in spinal cord injury. Abdominal bloating and constipation are primarily related to specific spinal cord levels of injury, whereas abdominal pain and fecal incontinence are primarily associated with higher levels of anxiety. Based on our findings, further physiologic and psychologic research studies in spinal cord injury patients should lead to more rational management strategies for the common gastrointestinal symptoms in spinal cord injury.

An internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia

The herbal extracts kava and valerian are the leading dietary supplements used in the self-management of anxiety and insomnia, respectively. There is limited evidence to support their effectiveness for these common symptoms. The Internet has been used to a limited extent for research, but it is not known whether randomized controlled trials can be conducted entirely using Internet technology. We performed a randomized, double-blind, placebo-controlled trial using a novel Internet-based design to determine if kava is effective for reducing anxiety and if valerian is effective for improving sleep quality. E-mail recruitment letters and banner advertisements on websites were used to recruit a large pool of interested participants (1551) from 45 states over an 8-week period. Participants were first asked to read study information, complete an online informed consent process, and undergo electronic identity verification. In order to be eligible for the study, participants were required to have 1) anxiety as documented by scores of at least 0.5 standard deviations above the mean on the State-Trait Anxiety Inventory State subtest (STAI-State) on 2 separate occasions, and 2) insomnia, defined as a "problem getting to sleep or staying asleep over the past 2 weeks." We randomly assigned 391 eligible participants to 1 of the following 3 groups, and mailed 28 days' supply: kava with valerian placebo (n = 121), valerian with kava placebo (n = 135), or double placebo (n = 135). The primary outcome measures were changes from baseline in anxiety (STAI-State questionnaire) and insomnia (Insomnia Severity Index [ISI]) compared with placebo. Participants receiving placebo had a 14.4 point decrease in anxiety symptoms on the STAI-State score and an 8.3 point decrease in insomnia symptoms on the ISI. Those receiving kava had similar reductions in STAI-State score (2.7 point greater reduction in placebo compared with kava; 95% confidence interval [CI], -0.8 to +6.2). Those receiving valerian and placebo had similar improvements in sleep (0.4 point greater reduction in the placebo than the valerian group; 95% CI, -1.3 to +2.1). Results were similar when limited to the 83% of participants who adhered to study compounds for all 4 weeks. Neither kava nor valerian relieved anxiety or insomnia more than placebo. This trial demonstrates the feasibility of conducting randomized, blinded trials entirely via the Internet.

The grooming analysis algorithm discriminates between different levels of anxiety in rats: potential utility for neurobehavioural stress research

Stress has long been known to affect grooming in rodent species, altering both its activity measures and behavioural microstructure. Since stress disturbs a general pattern of self-grooming uninterrupted cephalocaudal progression, the grooming analysis algorithm (Kalueff and Tuohimaa, Brain Res. Protocols, 2004; 15: 151-8) was previously designed for mice to enable the detection of stress by measuring alterations in grooming microstructure in different test situations. Since mice and rats are known to differ in their behaviours, including grooming, the aim of the current study was to test our approach in rats and evaluate the utility of this method for differentiation between high- and low-stress situations. For this, we have developed the rat grooming analysis algorithm (based on ethological analysis of incorrect transitions contrary to the cephalocaudal rule, interrupted grooming activity and the assessment of the regional distribution of grooming) and applied this algorithm to the light-exposed (high stress) and dark-exposed (low stress) groups of rats. Here, we show that the percentage of 'incorrect' transitions between different grooming patterns, the percentage of interrupted grooming bouts and altered regional distribution of grooming (less caudal grooming, more rostral grooming) may be used as behavioural markers of stress in rats. Our results suggest that this method can be a useful tool in neurobehavioural stress research including modelling stress-evoked states, psychopharmacological or behavioural neurogenetics research in rats.

Tramadol premedication in operative extraction of the mandibular third molar: a placebo-controlled crossover study

Anxiolytic drugs are widely used for premedication in oral surgery. Since anxiety is usually associated with the fear of pain, we tested the effects of the analgesic tramadol in premedication before operative extraction of the mandibular third molar under local anesthesia. In a double-blind crossover study, 20 patients were randomized to receive 100 mg oral tramadol or placebo 1 h before operation. Anxiety, nausea, dryness of the mouth, pain and discomfort were recorded before administration of the drug, immediately before and after operation, and 0.5, 1, and 2 h postoperatively using ungraded 0-100 mm VAS scales. Blood pressure and heart rate were measured at the same times; vigilance was tested using the Maddox Wing Test and sensorimotor performance using the Trieger Dot Test; hemoglobin oxygen saturation (SpO2) was measured using a pulse oximeter. In addition, SpO2 and heart rate were recorded continuously in nine patients using a pulse oximeter connected to a computer. The surgeon assessed the quality of operating conditions on the VAS scale. Tramadol delayed and decreased the need of analgesics on the day of operation (p < 0.05). The operating conditions were better in patients on tramadol premedication than in those on placebo during the first operation (p < 0.05), but no differences were seen in patient well-being between treatments. The second operation was less stressful than the first. Tramadol is recommended only with special indications for premedication of patients undergoing third molar extraction under local anesthesia.

Delirium: behavioural changes before and during the prodromal phase

BACKGROUND

Delirium is an important form of psychopathology in older people and is associated with increased morbidity and functional decline. In the prodromal phase of delirium early symptoms occur, before all criteria have been met.

AIM

The aim of this study was to delineate behavioural changes before and during the prodromal phase of delirium. That was considered to include the time from the first behavioural change up to the point when all DSM-IV criteria for delirium were met.

DESIGN

Prospective and descriptive observation study.

METHODS

One hundred and three hip surgery patients (hip fracture and hip replacement) aged > or = 80 years participated in this study. On admission none of them was delirious or had severe cognitive decline, but 32 patients met the DSM-IV criteria for delirium during the hospital stay. Frequent observations were performed up to delirium onset or 48 hours postoperatively. The observations included 37 items on the patient's state of mind, cognition, activity and behaviour. The first observation on admission was used as a reference and behavioural changes were defined as deviations from this first observation.

RESULTS

Twenty-one patients out of the 32 who met the DSM-IV criteria (62%, D group) demonstrated behavioural changes before delirium onset, as did 34 (48%, R group) out of the remaining 71 patients. The D group had different and more numerous behavioural changes than the R group. Anxiety was common in both groups. Disorientation and urgent calls for attention were the most frequent changes in the D group. The D group presented a pattern of behavioural changes and early symptoms of the approaching delirium. Six hours immediately before the onset of delirium, the behavioural changes were more numerous and evident.

CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE

It is necessary to pay attention to each behavioural change in the patients and to be aware of the prodromal phase of delirium in order to prevent its onset and to maintain the patient's well-being.

Desire for Control and Communication-Related Personality Variables

In a sample of 95 university students, scores on a measure of desire for control correlated .37 with willingness to communicate, supporting the notion of control as a motive for communication and also correlated .43 with self-perceived communication competence but not with communication apprehension.

A cross-sectional examination of changes in anxiety early after acute myocardial infarction

BACKGROUND

Anxiety is common after acute myocardial infarction (AMI). The assessment and treatment of anxiety early after AMI is important, because anxiety is associated with increased morbidity and mortality. Few data exist about anxiety early after AMI, the time when anxiety likely peaks. Furthermore, no researchers have evaluated potential gender differences in the evolution of anxiety after AMI.

OBJECTIVES

The purpose of this study was to investigate the evolution of anxiety during the first 72 hours of hospitalization for AMI and to examine whether there is a gender difference in the pattern of anxiety early after AMI, from cross-sectional data.

METHODS

In this cross-sectional study, 486 patients with AMI were recruited from 4 urban university medical centers and 2 private hospitals in the United States and 1 large university teaching hospital in Australia. The Spielberger State-Trait Anxiety Inventory was used to measure anxiety once in each patient within 72 hours of the patient's admission to the hospital. Patients were divided into 6 groups based on the time interval in which they were interviewed.

RESULTS

The mean score of state anxiety was 39 +/- 13. Peak anxiety occurred within the first 12 hours after AMI (P<.05) and anxiety level differed among the time intervals (F [5, 474]=4.55, P<.001). There was a main effect of gender on anxiety (F [1, 474]=11.86, P<.001). Women reported higher anxiety than men at all time points except the time interval of 24.1 to 36 hours after AMI.

CONCLUSION

Prospective, longitudinal, repeated measures research is needed to confirm the trajectory of anxiety in AMI patients, but data from this study suggest that anxiety should be assessed and treated in the early stages of AMI to prevent potential complications that may be exacerbated by anxiety and to provide comfort to AMI patients.

Predicting anxiety in magnetic resonance imaging scans

This study evaluated a brief screening instrument for predicting psychological distress in patients undertaking magnetic resonance imaging (MRI) scans. The scale is adapted from Wolpe and Lang's (1964) Fear Survey Schedule (FSS; see Lukins, Davan, & Drummond, 1997). Noise and/or confinement were identified as the most unpleasant feature of the MRI by 48.3% of 118 outpatients. The MRI-FSS (Lukins et al., 1997; 9 items) significantly predicted the number of panic attack symptoms and state anxiety experienced during MRI scan better than a range of other measures. There was a significant increase in MRI-FSS scores from prescan to postscan among those who experienced high levels of anxiety during the scan. The MRI-FSS appears to be a useful indicator of likely adverse psychological reactions in the MRI scan that is sensitive to the sequelae of the MRI procedure.

Transcription factor AP-2beta genotype associated with anxiety-related personality traits in women. A replication study

Attempts to link transmitter system genes to certain aspects of personality have been performed. Several monoamine-related gene variants have been investigated. We previously reported an association between a transcription factor activating protein-2beta (AP-2beta) variant and anxiety-related personality traits as estimated by Karolinska Scales of Personality (KSP). To confirm this reported association, we have, in the present study, analysed an enlarged group of healthy volunteers (n = 370) with regard to AP-2beta genotype and personality traits. For estimation of personality traits, individuals completed 5 different personality questionnaires, i.e. Swedish Universities Scales of Personality (SSP), Health-Relevant 5- Factor Personality Inventory (HP5i), Temperament and Character Inventory, the Revised NEO Personality Inventory and KSP. In contrast to men, women having two long AP-2beta alleles displayed lower scores for muscular tension (KSP; F = 10.65, p = 0.0013), somatic trait anxiety (SSP; F = 7.18, p = 0.0081), trait irritability (SSP; F = 4.51, p = 0.032), mistrust (SSP; F = 4.01, p = 0.0468) and negative affectivity (HP5i; F = 10.20, p = 0.0017) than women with at least one short allele. The data presented in this study, together with our previously published data, suggest that AP-2beta intron 2 genotype is associated with low levels of anxiety-related personality traits in women. Hence, these data further suggest the human AP-2beta gene as a novel candidate gene in personality.

The evaluation of anxiety and salivary cortisol levels in patients with oral lichen planus

OBJECTIVE

The aim of this study was to determine any association between anxiety and salivary cortisol levels in oral lichen planus (OLP) patients by the case-control method. DESIGN RELEVANT: Forty patients with OLP were evaluated. The OLP diagnosis was established through a composite of accepted clinical and histopathological characteristics. Forty patients from the register of patients who obtained general dental care were selected as controls.

MATERIAL AND METHOD

The saliva samples collected between 9:00 and 9:15 am were analysed for the level of cortisol with Cortisol EIA that used competitive enzyme-linked immunosorbent assay method. Trait and state anxiety levels of 80 patients were measured using the Spielberger's State-Trait Anxiety Inventory.

RESULTS

The mean level of cortisol from 40 saliva samples in study group was 1.46 and 0.93 microg dl(-1) in 40 controls (P=0.001). The mean level for state anxiety in the study group were 48.85 and 39.45 in control group (P=0.001). Trait anxiety levels in study group were 49.77 and 38.51 in control group (P=0.001). We found that salivary cortisol, state and trait anxiety levels in OLP group were significantly higher than in the control group.

CONCLUSION

Because of the fact that the level of anxiety and salivary cortisol of OLP patients were high, our findings concluded that this disease is closely related with stress. Thus besides traditional treatment of OLP patients, our findings suggest that psychological support is also needed.

Psychosocial outcomes of a pilot multidisciplinary program for weight management

OBJECTIVE

To investigate psychosocial effects of a 6-month pilot multidisciplinary weight-management program for young females.

METHODS

Participants (n=57), ages 8-15, completed the Revised Children's Manifest Anxiety Scale (RCMAS) and Self-Perception Profile for Children (SPPC) at baseline, 6 months, and 12 months.

RESULTS

Positive changes were noted in the scores of both surveys. Significant decreases occurred in the RCMAS mean Total Anxiety and Worry/Oversensitivity scores; significant increases were found in the SPPC mean Social Acceptance and Athletic Competence scores.

CONCLUSIONS

Enrollment in multifaceted weight-management programs that include stress management and social support may reduce anxiety level and enhance self-perception.

The Depression Anxiety Stress Scales (DASS): normative data and latent structure in a large non-clinical sample

OBJECTIVES

To provide UK normative data for the Depression Anxiety and Stress Scale (DASS) and test its convergent, discriminant and construct validity.

DESIGN

Cross-sectional, correlational and confirmatory factor analysis (CFA).

METHODS

The DASS was administered to a non-clinical sample, broadly representative of the general adult UK population (N = 1,771) in terms of demographic variables. Competing models of the latent structure of the DASS were derived from theoretical and empirical sources and evaluated using confirmatory factor analysis. Correlational analysis was used to determine the influence of demographic variables on DASS scores. The convergent and discriminant validity of the measure was examined through correlating the measure with two other measures of depression and anxiety (the HADS and the sAD), and a measure of positive and negative affectivity (the PANAS).

RESULTS

The best fitting model (CFI =.93) of the latent structure of the DASS consisted of three correlated factors corresponding to the depression, anxiety and stress scales with correlated error permitted between items comprising the DASS subscales. Demographic variables had only very modest influences on DASS scores. The reliability of the DASS was excellent, and the measure possessed adequate convergent and discriminant validity Conclusions: The DASS is a reliable and valid measure of the constructs it was intended to assess. The utility of this measure for UK clinicians is enhanced by the provision of large sample normative data.

The relationship of stress and anxiety with chronic periodontitis

AIM

This case-control study investigates the relationship of stress and anxiety with periodontal clinical characteristics.

METHOD

Seventy-nine selected patients (mean age 46.8+/-8 years) were assigned to three groups in accordance with their levels of probing pocket depth (PPD): control group (PPD< or =3 mm, n=22), test group 1 (at least four sites with PPD > or =4 mm and < or =6 mm, n=27) and test group 2 (at least four sites with PPD >6 mm, n=30). An inclusion criterion of the study required that patients presented a plaque index (PI) with a value equal to or larger than 2 in at least 50% of dental surfaces. All subjects were submitted to stress and anxiety evaluations. Stress was measured by the Stress Symptom Inventory (SSI) and the Social Readjustment Rating Scale (SRRS), while the State-Trait Anxiety Inventory (STAI) was used to assess anxiety. Clinical measures such as PI, gingival index (GI), PPD and clinical attachment level (CAL) were collected. Patient's medical history and socioeconomic data were also recorded.

RESULTS

The mean clinical measures (PI, GI, PPD and CAL) obtained for the three groups, were: control group, 1.56+/-0.32, 0.68+/-0.49, 1.72+/-0.54 and 2.04+/-0.64 mm; group 1, 1.56+/-0.39, 1.13+/-0.58, 2.67+/-0.67 and 3.10+/-0.76 mm, group 2, 1.65+/-0.37, 1.54+/-0.46, 4.14+/-1.23 and 5.01+/-1.60 mm. The three groups did not differ with respect to percentage of clinical stress, scores of the SRRS, trait and state anxiety. Frequency of moderate CAL (4-6 mm) and moderate PPD (4-6 mm) were found to be significantly associated with higher trait anxiety scores after adjusting for socioeconomic data and cigarette consumption (p<0.05).

CONCLUSIONS

Based on the obtained results, individuals with high levels of trait anxiety appeared to be more prone to periodontal disease.