Association between oral health-related quality of life and depressive symptoms in Chinese college students: Fitness Improvement Tactics in Youths (FITYou) project

Meta-analysis with systematic review to synthesize associations between oral health related quality of life and anxiety and depression

OBJECTIVES

The present systematic review aimed to investigate how oral health related quality of life (OHQOL) associates with anxiety and depression. The study protocol was registered prospectively in the PROSPERO database (CRD42023389372).

MATERIALS AND METHODS

Studies investigating associations between OHQOL and depression and/or anxiety were included. Fisher's Z scores were used to summarize associations between OHQOL and depression/anxiety. Funnel plots and Begg's Tests were used to assess publication bias. Meta-regression was conducted to examine potential moderator effects in the associations. Academic databases including the ISI Web of Knowledge, Scopus, ProQuest and PubMed were systematically searched. The quality of included studies was checked with the Newcastle Ottawa Scale (NOS).

RESULTS

All 15 included studies were cross-sectional (14,419 participants from nine countries; mean age=43.74 years). The pooled estimates showed weak associations between OHQOL and depression (Fisher's z-score of 0.26 [95% CI = 0.17, 0.35; I2 = 96.2%; τ2 = 0.03]) and anxiety (Fisher's z-score of 0.22 [95% CI = 0.001, 0.43; I2 = 97.9%; τ2 = 0.06]). No severe problems in methodology quality, publication biases, or moderator effects were observed.

CONCLUSION

Both depression and anxiety were weakly associated with individuals' OHQOL. Although the synthesized associations were not strong, they were significant, indicating that depression and anxiety are potential factors influencing individuals' OHQOL.

Oral health-related quality of life and depressive symptoms in adults: longitudinal associations of the English Longitudinal Study of Ageing (ELSA)

BACKGROUND

Little is known about the relationship between oral health status and depressive symptoms in adults in England. The aim of this study was to examine the longitudinal association between oral health parameters and depressive symptoms in adults in England.

METHODS

Data were obtained from the English Longitudinal Study of Aging (ELSA), which included information on self-rated oral health, oral impairment in daily life (Oral Impacts on Daily Performances, OIDP), and depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D) in 6790 adults aged ≥ 50 years. Wave 3 data were used as baseline, while Waves 5 and 7 were used for follow-up assessments. Logistic regression was used to determine whether depressive symptoms at baseline anticipated self-rated oral health and OIDP and whether oral health status (at baseline) was associated with the development of depressive symptoms at follow-up assessment.

RESULTS

Participants with poor self-rated oral health were at higher risk of developing depressive symptoms, even after adjusting for behavioral, clinical, and sociodemographic characteristics (OR = 1.69, 95% CI 1.38-2.07). Similarly, having oral impacts on daily performances were associated with the development of depressive symptoms: The OR for developing depressive symptoms at Wave 5 or 7 was 2.19 (95% CI 1.62-2.96) after adjustment for all covariates. Participants with depressive symptoms at baseline were more likely to report poor self-rated oral health (OR = 1.93, 95% CI 1.52-2.44) or one or more oral impacts (OR = 1.86, 95% CI 1.45-2.40) at follow-up than those without depressive symptoms at baseline, even after adjusting for confounders.

CONCLUSIONS

In the present study, a bidirectional association was found between depressive symptoms and poor oral health in older adults. Maintaining good oral health in older adults may be a protective factor against depressive symptoms. Therefore, more attention should be paid to promoting oral health awareness in older adults, including encouraging regular dental checkups, proper toothbrushing and flossing techniques, and healthy lifestyles.

Assessment of the professional dental cleaning knowledge, behavior and medical compliance among dentists, medical doctors and non-medical staffs: a cross sectional study in Chongqing, China

BACKGROUND

The professional dental cleaning (PDC) is an effective supplement that can make up for the lack of self-oral health care. Everyone should develop the habit of regular PDC. This study aimed to investigate the knowledge, behaviors and medical compliance of dentists, medical doctors and non-medical staffs about the PDC, identify the gaps, and provide information to help individuals develop healthy oral hygiene habit.

MATERIALS AND METHODS

A web-based survey with 21 questions designed based on the characteristics, the PDC knowledge, behaviors, and medical compliance of respondents. A cross-sectional study was conducted in the main districts of Chongqing, China, in the period of September-November 2020. A total of 456 respondents including 153 dentists, 137 medical doctors and 166 non-medical staffs in 3 communities and 4 hospitals were sampled online with multistage sampling and surveyed. The data was analyzed by chi-square test using IBM SPSS Statistics v. 21.0.

RESULTS

The cognitive level and behavior of dentists on the PDC was significantly better than that of medical doctors and non-medical staffs (p = 0.000-0.044). The rates of not knowing "dental plaque" were 32.85% and 61.45%, of the medical doctors and non-medical staffs. Meanwhile, most of them had misunderstanding about effects of the PDC. They thought it would whiten teeth (72.99%, 80.72%), damage gums (16.79%, 19.88%) and teeth (15.33%, 21.69%), and create bigger gaps between teeth (24.82%, 33.13%). In terms of gum health and the PDC behavior, significant differences were observed, 23.53% of dentists experienced irritated gum bleeding in the last 12 months, 42.28% did not have their teeth cleaned professionally in the last 12 months, even 7.84% never had it before. Compared with it, in the same situation, the ratios of medical doctors and non-medical staffs were about 60% experiencing irritated gum bleeding, 69.34% and 77.71% not experiencing the PDC in the last 12 months, up to 33.58% and 45.18% never experienced it before. 41 respondents (8.99%) disagreed with the reasonable and necessary medical behaviors before the PDC.

CONCLUSION

People's understanding about the PDC was insufficient, and many people, included some dentists, had not developed the habit of regular dental cleaning. Our study provided a new understanding of the PDC among dentists, medical doctors, and non-medical staffs, which may help to improve their awareness and behavior of oral hygiene health, and establish the multidisciplinary collaborations between dentists and medical doctors.

Studying suicide using proxy-based data: reliability and validity of a short version scale for measuring quality of life in rural China

Background

To evaluate the reliability and validity of the short version six-item Quality of Life Scale (QOLS-6) and the consistency of subject-proxy data in a case-control psychological autopsy study on elderly suicide in rural China.

Methods

A two-stage stratified cluster sampling method was used to select research sites. We used self-administered questionnaires to collect proxy-based information from informants and subject-based information from living comparisons.

Results

A total of 242 pairs of suicide cases and living comparisons were selected in our research. Subject-proxy consistency for QOLS-6 was good (Intraclass correlation coefficient (ICC) was 0.688) in living controls. Good internal consistency of QOLS-6 was validated by Cronbach’s α being greater than 0.6 among suicide cases and living comparisons. The mean scores of quality of life were lower among suicide cases than living controls. Quality of life was negatively correlated with depression, loneliness, hopelessness, impulsiveness and stressful life events, while it was positively correlated with activities of daily living and family function.

Conclusions

QOLS-6 has good reliability and validity, which can be used for assessing quality of life among Chinese rural older adults. It is shorter and easier than any other scale for measuring quality of life and can be used as a screening tool in future studies.

Impact of psychological states on periodontitis severity and oral health-related quality of life

PURPOSE

This cross-sectional study aimed to identify impacts of depression, anxiety and stress on periodontitis severity and oral health-related quality of life (OHRQoL).

METHODS

A total of 141 periodontitis patients were recruited. Psychological states were assessed using the Malay short-form Depression, Anxiety and Stress Scales (MDASS-21). Subjects were grouped as positive for depression, anxiety or stress (DAS) (positive-DAS), without DAS (non-DAS), stress-only and anxiety-only. OHRQoL was evaluated using the Malay short-form Oral Health Impact Profile (S-OHIP[M]).

RESULTS

OHRQoL was associated with MDASS-21, probing pocket depths, recession, clinical attachment levels, number of teeth present and number of teeth with mobility. S-OHIP(M) of positive-DAS subjects was associated with clinical attachment levels, number of teeth present and presence of anxiety. Anxiety-only subjects reported higher S-OHIP(M) scores compared to the non-DAS group.

CONCLUSION

OHRQoL of all subjects was negatively impacted by periodontitis severity and tooth loss. Combinations of depression, anxiety or stress led to worse periodontal status and OHRQoL. Subjects with anxiety-only experienced poorer OHRQoL compared to those without depression, anxiety and stress regardless of periodontitis severity. Possible impacts of psychological states on periodontitis and OHRQoL highlights the importance of assessing and improving psychological factors as part of periodontal therapy and to enhance OHRQoL.

Association Between Parental Socioeconomic Status and Skeletal Muscle Mass in Chinese College Students: Fitness Improvement Tactics in Youths (FITYou) Project

Purpose

The purpose of this study was to determine the association between parental socioeconomic status (SES) and skeletal muscle mass in Chinese college students.

Methods

A cross-sectional study including 2204 college freshmen was conducted in Shenyang, China. Data regarding body composition, health examinations, and a self-reported questionnaire were available from all the participants. Skeletal muscle mass assessment was completed by a bioelectrical impedance analyzer. Information on parental SES (educational levels, annual income, and occupational status) was collected via questionnaires. Covariance analysis was used to adjust for the confounding effects of sex, age, ethnicity, smoking status, alcohol use, and sleep duration.

Results

Multivariate analysis showed that college freshmen with higher parental SES levels generally had higher skeletal muscle mass after adjustment for confounding factors (mean [95% confidence interval]: low, 42.4 [42.0, 42.8]; middle, 42.9 [42.6, 43.3]; high, 43.7 [43.4, 44.1], p for trend < 0.001). Similar results were observed for paternal and maternal SES (p for trend < 0.001, respectively), whereas association between paternal SES and youth muscle mass became non-significant after adjusting for maternal SES (p for trend = 0.077). Results also showed positive linear trends for skeletal muscle mass and paternal or maternal educational levels and annual income (p for trend < 0.001, respectively), but not for occupational status.

Conclusion

This study found a positive association between parental SES and skeletal muscle mass in Chinese college students. Compared to the normalization of height or weight, body mass index-adjusted skeletal muscle mass is more likely to be associated with SES.

Intensity of Physical Activity and Depressive Symptoms in College Students: Fitness Improvement Tactics in Youth (FITYou) Project

Purpose

To investigate whether the physical activity at different intensities is correlated with depressive symptoms in college students.

Patient and Methods

This cross-sectional study was a part of the Fitness Improvement Tactics in Youth Project, which was conducted in 2017. A total of 2,820 college freshmen aged 15-24 years were included in this study, of whom 699 (24.8%) were males and 2,121 (75.2%) were females. Depressive symptoms were measured using the Self-rating Depression Scale. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form. Covariates included sociodemographic, lifestyle-related, and health-related factors.

Results

A total of 560 (19.9%) college students had depressive symptoms. Total physical activity levels (METs•hour/week) were positively associated with frequency of breakfast intake (p = 0.050) but no other participant characteristics. Logistic regression analysis showed that the prevalence of depressive symptoms in the highest quartile of physical activity was lower than in the lowest quartile when adjusted for sex, age, ethnicity, only child, smoking status, alcohol use, breakfast frequency, daily sleep duration, body mass index, grip strength, and the number of metabolic syndrome components (odds ratios [95% confidence intervals (CI)]: 0.75 [0.58, 0.98], p = 0.036). Furthermore, high physical activity levels of low-intensity tended to moderately correlate to lower prevalence of depressive symptoms (odds ratios [95% CI]: Q1, 0.71 [0.55, 0.91], Q2, 0.77 [0.59, 1.01], Q3, 0.75 [0.57, 0.98], p for trend = 0.037). Associations of moderate and vigorous physical activity with depressive symptoms were not found. For secondary outcomes, sex-stratified analysis showed that similar findings were only found in females, but not males.

Conclusion

This study indicated that total physical activity and low-intensity physical activity were inversely associated with depressive symptoms in Chinese college students. All these observations showed gender differences.

Night-Eating Syndrome and Depressive Symptoms in College Freshmen: Fitness Improvement Tactics in Youths (FITYou) Project

Background

Emerging evidence has shown that night-eating syndrome is correlated to depressive symptoms. However, these studies were mainly small-scale investigations.

Purpose

This study aimed to examine the association of night-eating syndrome with depressive symptoms among college students using a large-scale sample.

Methods

A cross-sectional study, which was a part of the Fitness Improvement Tactics in Youth Project, was conducted in 2017. The current study included 3278 college freshmen from Shenyang, China. They completed self-administered questionnaires and provided their sociodemographic and lifestyle information. Night-eating syndrome was assessed using the night-eating questionnaire (NEQ). Depressive symptoms were measured using the Self-rating Depression Scale (SDS).

Results

Of participants, 5.4% had night-eating syndrome (NEQ score ≥30), and 21.3% had depressive symptoms (SDS score ≥53). Prevalence of night-eating syndrome was higher in male than female students (p = 0.006). Logistic regression analysis indicated that students with night-eating syndrome had a higher prevalence of depressive symptoms than those without the syndrome after adjusting covariates (odds ratios [95% CI]: 3.28 [2.40, 4.48], p < 0.001). Consistent results were found when night-eating syndrome was defined as NEQ score ≥25. In addition, analysis of covariance showed a significant association between NEQ quartiles and SDS score (mean [95% CI]: Q1, 44.4 [43.8, 45.0]; Q2, 43.4 [42.7, 44.0]; Q3, 44.4 [43.7, 45.1]; Q4, 47.5 [46.9, 48.2], p < 0.001 for linear and quadratic trend).

Conclusion

This study showed an association between night-eating syndrome and depressive symptoms among Chinese college freshmen.