Periodontal status and the efficacy of the first‐line treatment of major depressive disorder

• Published in: Clinical and experimental dental research Vol. 8; no. 1; pp. 366 - 373
• Main Authors: Jelavić, Silvana, Bajić, Žarko, Filipčić, Ivona Šimunović, Čulina, Ivana Jurčić, Filipčić, Igor, Aurer, Andrej
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01-02-2022; John Wiley and Sons Inc; Wiley
• Subjects: Age; Alzheimer's disease; Antidepressants; Clinical outcomes; Data collection; Dentistry; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - epidemiology; Drug dosages; Gum disease; Hospitals; Humans; Hypotheses; major depressive disorder; Mental depression; oral health; Original; Patients; periodontal attachment loss; periodontal disease; Periodontal Diseases - epidemiology; Periodontal Diseases - therapy; Prospective Studies; Psychiatric Status Rating Scales; Quality of Life; Schizophrenia; selective serotonin uptake inhibitors; Software; SSRI; Croatia; selective serotonin uptake inhibitors; SSRI; oral health; periodontal attachment loss; major depressive disorder; periodontal disease
• ISSN: 2057-4347; 2057-4347
• DOI: 10.1002/cre2.492

Objectives
The efficacy of treatment of major depressive disorder (MDD) is not satisfactory. Systemic inflammation may play an important role in MDD pathogenesis and treatment outcomes. Periodontal disease is the systemic inflammatory condition. Its prevalence may be as high as 45%. We aimed to assess the association of periodontal status with the outcome of 3‐month first‐line treatment of MDD with selective serotonin reuptake inhibitors.
Material and Methods
We performed the prospective cohort study during 2018/2019 at Psychiatric Hospital “Sveti Ivan,” Croatia, on a consecutive sample of 43 patients. The outcome was the MDD symptoms severity measured using the Hamilton Depression Rating Scale‐17. The periodontal status was indicated by the clinical attachment loss (CAL).
Results
Baseline periodontal status had a nonlinear significant and clinically relevant association with the MDD treatment outcome (R2 change of the quadratic term = 0.12; p = 0.027). In patients with good baseline periodontal status the severity of MDD symptoms was significantly improved. When the value of CAL was ≥4.44 mm, indicating the worse periodontal status, further increase in baseline CAL was associated with the worsening of MDD treatment outcomes independently of the baseline depression severity and 14 sociodemographic and clinical predictors of treatment outcome.
Conclusions
Periodontal healthcare is accessible, and should be utilize in an integrative, multidisciplinary approach not only for the sake of psychiatric patients' quality of life and prevention of periodontal disease, but for the sake of the outcomes of psychiatric treatment as well.