Citation Information :
Waingade M, Medikeri RS, Mahajan M. Correlation of Salivary Cortisol with Stress, Anxiety and Depression in Oral Lichen Planus: A Systematic Review and Meta-analysis. World J Dent 2022; 13 (1):70-79.
Aim: The aim of this study was to evaluate and correlate the salivary cortisol levels with depression, anxiety and stress scores in patients with OLP.
Background: Oral lichen planus (OLP) is an immunopathological disease where patients often relate the onset and aggravation of symptoms to increased levels of depression/anxiety/stress. Research suggests that salivary cortisol can be considered as a biomarker of stress. Psychosomatic diseases such as OLP validate the role of depression/anxiety/stress so that they can be effectively and comprehensively treated. A comprehensive electronic literature search was performed by using scientific databases MEDLINE, PubMed Central, Directory of Open Access Journal, Cochrane and Google Scholar. Studies included case control/cross-sectional studies in which the detection of salivary cortisol levels of the OLP patients and controls was assessed along with assessment of DAS with questionnaire/scales. Quality assessment was done using modified Newcastle–Ottawa Quality assessment scale (NOS) and The Joanna Briggs Institute (JBI) Critical Appraisal tool.
Review results: Eleven studies comprising 260 OLP patients and 253 controls were included. The results suggest that the depression/anxiety/stress scores were higher in OLP patients than controls. The anxiety, depression and stress scores showed statistically non-significant correlation with salivary cortisol in OLP.
Conclusion: The psychological factors including stress, anxiety and depression plays a crucial role in pathogenesis of OLP. So, supportive psychological treatment also needs to be considered while treating OLP patients.
Clinical significance: Oral lichen planus (OLP) is a psychosomatic disorder and salivary cortisol is biomarker of stress. The psychological factors including stress, anxiety and depression play a crucial role in pathogenesis of OLP. We reported higher salivary levels of cortisol and higher scores of anxiety, depression and stress in OLP patients compared to controls. Similarly, no correlation between anxiety, depression and stress scores with salivary cortisol is established. Thus, we recommend supportive psychological treatment together with the conventional therapy could increase patients’ capability to deal with psychological instabilities that can improve the OLP healing.
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