Anxiety, Depression and Somatization in Patients with Oral Lichen Planus

Abstract

Psychosocial factors have been mentioned frequently to be associated with oral lichen planus (OLP). However, these comorbidities have not been explored as frequently in patients with oral lichenoid lesions (OLL). Most of the cited OLP/OLL studies appear to be anecdotal or lack appropriate control groups. The primary aim of this study was to assess anxiety, depression, and somatization (with and without pain) in patients suffering from OLP/OLL using the Symptom Checklist (SCL-90R), compared to patients with myofascial pain and healthy controls. Another objective of this study was to determine and compare the levels of pain aversiveness and pain intensity of OLP and OLL patients. This cross-sectional study identified 152 OLP/OLL eligible subjects who attended the Oral Medicine Clinical Services (OMCS) at University of Washington between January 2011 and March 2017. The SCL-90R subscales, Visual Analog Scale (VAS) for pain intensity and pain aversiveness, and sociodemographic variables of the study groups were assessed. For the SCL-90R subscales of anxiety, depression and somatization, the myofascial pain group had the highest median scores followed by the OLP group, OLL group and finally the control group as hypothesized. For somatization without pain, the OLP group had the highest median score followed by myofascial pain subjects, OLL patients and finally controls. There was a significant difference between patients with OLP and controls with regard to somatization without pain. However, no statistical significant differences were seen between patients with OLP, patients with OLL and controls with regard to anxiety, depression and somatization subscales when adjusted for age and gender, though a trend approaching significance was seen in OLP patients with higher risk to have moderate/severe anxiety than controls. This study found that the patients with OLP are likely to experience psychosocial comorbidities, which indicate that psychological assessment should be routinely done for these patients.