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Soares GH, Bado FMR, Lopes AG, Biazevic MGH, Michel-Crosato E, Mialhe FL. Structure and replicability of oral health-related quality of life networks across patients with schizophrenia and the general community. Community Dent Oral Epidemiol 2023; 51:1216-1224. [PMID: 37166109 DOI: 10.1111/cdoe.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/31/2023] [Accepted: 05/02/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES Schizophrenia is a disabling mental disorder associated with severe social dysfunction. Individuals with long-term mental conditions have poorer Oral Health-Related Quality of Life (OHRQoL) compared to the general population, but little is known about the measurement properties of OHRQoL instruments in this group of patients. This study aimed to examine the replicability of OHRQoL networks across samples of the general community (GC) and patients with schizophrenia (PWS). METHODS Data were obtained from 603 community-dwelling participants and 627 patients with schizophrenia. OHRQoL was measured using the short form of the Oral Health Impact Profile (OHIP-14) questionnaire. A regularized partial correlation network was estimated for each sample. The number of dimensions and structural stability were assessed using Exploratory Graph Analysis. Global strength, edge weights and centrality estimates were compared. Network replicability was examined fitting the PWS data to the GC network structure. RESULTS A single OHIP-14 dimension was identified in the GC sample, whereas three dimensions were detected in the PWS sample. Structural consistency was perfect in the network of GC participants (1), and considerably low in at least two dimensions of the PWS network (0.28; 0.65; 0.16). A moderate correlation for node strength estimates was observed (τ: 0.43; 95% CI: 0.13, 0.72), although edge weights were not correlated (τ: 0.025; 95% CI: -0.11, 0.16). The fit of the PWS data to the GC network structure was deemed unacceptable. CONCLUSION Network models of OHRQoL did not replicate across samples of the general community and outpatients with schizophrenia. Prudent use of OHIP-14 to compare measures of OHRQoL between groups with significant cognitive impartment and the general population is recommended.
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Affiliation(s)
- Gustavo Hermes Soares
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | | | | | | | | | - Fabio Luiz Mialhe
- Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Santhosh Kumar S, Cantillo R, Ye D. The Relationship between Oral Health and Schizophrenia in Advanced Age-A Narrative Review in the Context of the Current Literature. J Clin Med 2023; 12:6496. [PMID: 37892634 PMCID: PMC10607055 DOI: 10.3390/jcm12206496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/13/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Schizophrenia is a psychiatric disorder that makes patients incompetent to perform day-to-day activities due to their progressing mental illness. In addition to disturbances with thoughts, behavioral changes, and impaired cognitive functions, oro-systemic health also becomes compromised. Even though the population with schizophrenia is primarily made up of older people, little is known about this group's oral health treatment. The present review explores the relationship between oral healthcare and elderly patients with schizophrenia. Our literature search included databases, like PubMed, Embase, and Google Scholar, for appropriate and evidence-based information. Preventive and management strategies outlined in the included articles and future research perspectives in this field are discussed. To the best of our knowledge, this is the first review that looked at dental care and related characteristics in older schizophrenia patients. The findings highlight the necessity for targeted dental interventions to address the dental health challenges faced by this vulnerable population. Integrating dental health into the overall medical management of elderly individuals with schizophrenia is crucial. Although specific therapies remain limited, the emphasis is on preventive dentistry to reduce the occurrence and progression of oral diseases in this group.
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Affiliation(s)
| | | | - Dongxia Ye
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14620, USA or (S.S.K.); or (R.C.)
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Kanniappan V, Abishek JR. Hermeneutic Phenomenological Approach to the Experiences of the Individuals Living with Schizophrenia: A Qualitative Study. Indian J Community Med 2023; 48:762-770. [PMID: 37970156 PMCID: PMC10637608 DOI: 10.4103/ijcm.ijcm_172_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/08/2023] [Indexed: 11/17/2023] Open
Abstract
Background Schizophrenia affects various spheres of life causing so many difficulties and burden, but the studies focusing on the experience of individuals living with schizophrenia with reference to the Tamil Nadu context are sparse. Material and Methods A qualitative interview based on a hermeneutic phenomenological approach was conducted with 10 individuals living with Schizophrenia and was recorded. The responses were transcribed and coded. Based on codes, domains and subdomains were identified. Results Six themes were identified, under which the participant's burden was described. Participants expressed a deep longing for love and care. They were deprived of family's affection. Participants felt economically insecured, which was owing to their unemployment. Participants had many physical complaints including sleep disturbance and fatigue. Participants expressed that they had failing memory, concentration issues, and difficulty in planning. Most of the participants felt isolated by family and kin. They did not participate in much social activities due to the fear of judgment and stigmatization. Conclusion The experience of individuals living with Schizophrenia revealed that they experienced a series of burdens owing to their illness and its impacts that were categorized into various themes including physical, vocational, cognitive, psychological, personal, and social factors.
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Affiliation(s)
- Vadivelan Kanniappan
- Professor, SRM College of Physiotherapy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - J R Abishek
- PhD Scholar, SRM College of Physiotherapy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
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Denis F, Rat C, Cros L, Bertaud V, El-Hage W, Jonval L, Soudry-Faure A. Effectiveness of a Therapeutic Educational Oral Health Program for Persons with Schizophrenia: A Cluster Randomized Controlled Trial and Qualitative Approach. Healthcare (Basel) 2023; 11:1947. [PMID: 37444782 DOI: 10.3390/healthcare11131947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The oral health of people with schizophrenia (PWS) is very poor, suggesting a need for oral health promotion programmes with a high level of evidence. The aim of the EBENE study (Clinicaltrials.gov: NCT02512367) was to develop and evaluate the effectiveness of a multidisciplinary therapeutic educational programme in oral health (TEPOH) for PWS. METHODS A multicentre cluster randomised controlled trial, with outpatient psychiatry centres as the unit of randomisation, was designed to compare the effectiveness of TEPOH (intervention group) versus standard care (control group). The trial was conducted in 26 outpatient psychiatry centres in France (14 in the intervention group, 12 in the control group). Eligible patients with a diagnosis of schizophrenia were enroled between 2016 and 2020 and followed for 6 months. The TEPOH group received a multicomponent intervention (comprising an introductory session, three educational sessions, and a debriefing session). The primary endpoint was the evaluation of periodontal disease as a community periodontal index (CPI) score ≥ 3 at Month 6. The trial was completed using a qualitative approach based on semi-structured interviews with caregivers conducted between July 2018 and December 2019. The trial was stopped early due to difficulties in recruiting patients. RESULTS Overall, 81 patients (of 250 planned) were included, and 54 patients completed the trial: 40 in the TEPOH group and 14 in the control group. At baseline, the percentage of CPI ≥ 3 was 42.5% in the TEPOH group and 9.1% in the control group. At Month 6, the percentage of CPI ≥ 3 was 20% in the TEPOH group and 14.3% in the control group. The qualitative evaluation underlined that the professionals emphasised the "seriousness" and "assiduity" of the patients' participation in this programme and that the TEPOH reinforced carers' investment in oral hygiene. It also highlighted structural factors (lack of resources for professionals, lack of teeth in PWS, COVID-19 pandemic) that may have exacerbated the difficulties with enrolment and follow-up. CONCLUSIONS The effectiveness of this TEPOH, developed for PWS as part of the EBENE study, has not been demonstrated. Certain aspects of the programme's content and implementation need to be reconsidered. In particular, an adapted subjective measurement scale should be developed.
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Affiliation(s)
- Frederic Denis
- Faculty of Dentistry, Tours University, 37000 Tours, France
- EA 75-05 Education, Ethics, Health, Faculty of Medicine, François-Rabelais University, 37000 Tours, France
| | - Corinne Rat
- Clinical Research Unit, La Chartreuse Psychiatric Center, 21033 Dijon, France
| | - Lucie Cros
- Instance Régionale d'Education et Promotion de la Santé, 76100 Rouen, France
| | - Valerie Bertaud
- Health Big Data, LTSI-INSERM U 1099, University of Rennes 1, 35043 Rennes, France
- Rennes University Hospital, Guillaume Regnier Hospital, 35700 Rennes, France
| | - Wissam El-Hage
- CIC 1415, U 1253 iBrain, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire (CHRU), 37000 Tours, France
| | - Lysiane Jonval
- USMR-Réseau d'Aide Méthodologiste, University Hospital of Dijon, CEDEX, 21079 Dijon, France
| | - Agnès Soudry-Faure
- USMR-Réseau d'Aide Méthodologiste, University Hospital of Dijon, CEDEX, 21079 Dijon, France
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Joury E, Kisely S, Watt RG, Ahmed N, Morris AJ, Fortune F, Bhui K. Mental Disorders and Oral Diseases: Future Research Directions. J Dent Res 2023; 102:5-12. [PMID: 36081351 DOI: 10.1177/00220345221120510] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The poor physical health (including oral health) of people with mental disorders is a global problem. The burden of oral diseases among this group is substantial given their high prevalence and ability to increase the personal, social, and economic impacts of mental disorders. This article summarizes causes of mental disorders and oral diseases, critically reviews current evidence on interventions to reduce the burden of oral diseases in people with mental disorders, and suggests future research directions. The relationship between mental disorders and oral diseases is complex due to the shared social determinants and bidirectional interaction mechanisms that involve interconnected social, psychological, behavioral, and biological processes. Research has, to date, failed to produce effective and scalable interventions to tackle the burden of oral diseases among people with mental disorders. Transformative research and actions informed by a dynamic involvement of biological, behavioral, and social sciences are needed to understand and tackle the complex relationship between mental disorders and oral diseases, as well as inform the design of complex interventions. Examples of future research on complex public health, health service, and social care interventions are provided. The design and testing of these interventions should be carried out in real-world settings, underpinned by the principles of coproduction and systems thinking, and conducted by a transdisciplinary team. We propose this starts with setting research priorities and developing complex intervention theory, which we report to support future research to improve oral health and hence physical and mental health in this disadvantaged group.
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Affiliation(s)
- E Joury
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, The Royal London Hospital, London, UK
| | - S Kisely
- PA-Southside Clinical Unit, School of Clinical Medicine, Faculty of Medicine, the University of Queensland, Woolloongabba, QLD, Australia
| | - R G Watt
- Research Department of Epidemiology & Public Health, University College London, London, UK
| | - N Ahmed
- Bristol Dental School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - A J Morris
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - F Fortune
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, London, UK
| | - K Bhui
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
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Study of the Unidimensionality of the Subjective Measurement Scale of Schizophrenia Coping Oral Health Profile and Index: SCOOHPI. Behav Sci (Basel) 2022; 12:bs12110442. [DOI: 10.3390/bs12110442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The Schizophrenia Coping Oral Health Profile and Index (SCOOHPI) scale studies the coping strategies of schizophrenic patients with regard to oral health. The structural validity of this scale is studied has been studied using factor analyses. In this article, we study the unidimensionality of the SCOOHPI scale to use it as an index. Methods: We studied the internal consistency of the items of the SCOOHPI scale. Then, we studied the construct validity. The unidimensionality of the SCOOHPI scale was studied by the partial credit model. Results: The data used in this study come from five hospitals, and the total number of individuals participating in this study is 96, of which 72% are men and 59% are smokers. The SCOOHPI scale has good internal consistency (α = 0.84). The validity of divergence was checked by the absence of correlation between the SCOOHPI scale and the GOHAI (General Oral Health Assessment Index) scale. The unidimensionality of the SCOOHPI scale with data smoothing was demonstrated by the partial credit model. Conclusion: In this study, we completed the study of the psychometric validation of the SCOOHPI. The SCOOHPI scale can then contribute to improving evaluation of the coping strategies of schizophrenic patients with regard to oral health.
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Siu-Paredes F, Rude N, Rouached I, Rat C, Mahalli R, El-Hage W, Rozas K, Denis F. Dimensional Structure and Preliminary Results of the External Constructs of the Schizophrenia Coping Oral Health Profile and Index (SCOOHPI). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12413. [PMID: 34886138 PMCID: PMC8656529 DOI: 10.3390/ijerph182312413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022]
Abstract
The Schizophrenia Coping Oral Health Profile and Index (SCOOHPI) was developed to assess oral health coping strategies in people with schizophrenia. We show that the difficulty and discrimination indices of 18 items, selected for the final version, are acceptable according to the Rasch model, as are the inter-item (0.25) and inter-score (α = 0.85) correlations. This scale can be considered as an index, giving a global score between 0 and 72, with a Likert scale with five response modalities. This is also a profile with the following three dimensions of coping-related oral health, emerging independently of each other: (1) physical well-being strategies (α = 0.72); (2) moral well-being strategies (α = 0.60); (3) access strategies for oral well-being (α = 0.79). The sub-scores, ranging from 0 to 24, specify populations focused on the themes of coping strategies that may be most affected, depending on the subject's characteristics and their clinical oral health status. The validation study of this scale is still in progress, to evaluate the reproducibility of the results, sensitivity to change, and reliability for other populations of people with schizophrenia.
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Affiliation(s)
- Francesca Siu-Paredes
- Faculty of Dentistry, Champagne-Ardenne of Reims University Hospital, 51100 Reims, France; (F.S.-P.); (K.R.)
- UR 481 Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, University of Bourgogne Franche-Comté, 25000 Besançon, France; (N.R.); (I.R.)
| | - Nathalie Rude
- UR 481 Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, University of Bourgogne Franche-Comté, 25000 Besançon, France; (N.R.); (I.R.)
| | - Ines Rouached
- UR 481 Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, University of Bourgogne Franche-Comté, 25000 Besançon, France; (N.R.); (I.R.)
| | - Corinne Rat
- Clinical Research Unit, La Chartreuse Hospital Center, 21000 Dijon, France;
| | - Rachid Mahalli
- Department of Odontology, Tours University Hospital Center, 37000 Tours, France;
| | - Wissam El-Hage
- U1253, iBrain, CIC1415, Inserm, University Hospital Centre, Université de Tours, 37000 Tours, France;
| | - Katherine Rozas
- Faculty of Dentistry, Champagne-Ardenne of Reims University Hospital, 51100 Reims, France; (F.S.-P.); (K.R.)
| | - Frédéric Denis
- Department of Odontology, Tours University Hospital Center, 37000 Tours, France;
- Faculty of Dentistry, Nantes University, 44000 Nantes, France
- EA 75-05 Education, Ethics, Health, Faculty of Medicine, François-Rabelais University, 37000 Tours, France
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Maitre Y, Mahalli R, Micheneau P, Delpierre A, Guerin M, Amador G, Denis F. Pre and Probiotics Involved in the Modulation of Oral Bacterial Species: New Therapeutic Leads in Mental Disorders? Microorganisms 2021; 9:1450. [PMID: 34361886 PMCID: PMC8306040 DOI: 10.3390/microorganisms9071450] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022] Open
Abstract
This systematic review aims to identify probiotics and prebiotics for modulating oral bacterial species associated with mental disorders. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline, we search the electronic MEDLINE database published till January 2021 to identify the studies on probiotics and/or prebiotics for preventing and treating major oral dysbiosis that provokes mental disorders. The outcome of the search produces 374 records. After excluding non-relevant studies, 38 papers were included in the present review. While many studies suggest the potential effects of the oral microbiota on the biochemical signalling events between the oral microbiota and central nervous system, our review highlights the limited development concerning the use of prebiotics and/or probiotics in modulating oral dysbiosis potentially involved in the development of mental disorders. However, the collected studies confirm prebiotics and/or probiotics interest for a global or targeted modulation of the oral microbiome in preventing or treating mental disorders. These outcomes also offer exciting prospects for improving the oral health of people with mental disorders in the future.
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Affiliation(s)
- Yoann Maitre
- Emergency Department, Montpellier University Hospital, 2415 Montpellier, France;
- Aide à la Décision pour une Médecine Personnalisée, Université de Montpellier, 2415 Montpellier, France
| | - Rachid Mahalli
- Department of Odontology, Tours University Hospital, 7505 Tours, France; (R.M.); (P.M.); (A.D.)
| | - Pierre Micheneau
- Department of Odontology, Tours University Hospital, 7505 Tours, France; (R.M.); (P.M.); (A.D.)
| | - Alexis Delpierre
- Department of Odontology, Tours University Hospital, 7505 Tours, France; (R.M.); (P.M.); (A.D.)
| | - Marie Guerin
- Faculty of Dentistry, Clermont-Ferrand University, 63000 Clermont-Ferrand, France;
| | - Gilles Amador
- Faculty of Dentistry, Nantes University, 44035 Nantes, France;
| | - Frédéric Denis
- Department of Odontology, Tours University Hospital, 7505 Tours, France; (R.M.); (P.M.); (A.D.)
- Faculty of Dentistry, Nantes University, 44035 Nantes, France;
- Faculté de Médecine, Education, Ethique, Santé, Université François-Rabelais, 7505 Tours, France
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