Severity of illness and extra pyramidal symptoms as predictors for oral diseases among patients with schizophrenia

Abstract

Objective: The study explores the association between severity of illness (positive, negative, depressive and cognitive symptoms) and extra pyramidal symptoms (EPS) with dental caries, periodontal disease and prosthetic needs among patients with schizophrenia.

Material and methods: A total of 71 schizophrenic patients diagnosed based on ICD-10 criteria participated in the study. Clinical Global Impression – Schizophrenia (CGI–SCH) scale was used to evaluate positive, negative, depressive, cognitive symptoms and overall severity of schizophrenia. Simpson–Angus Scale (SAS) was used for assessment of EPS. Dental examinations were conducted as per WHO (1997) criterion.

Results: Mean DMFT and CPI scores with periodontal pockets were 5.57 ± 2.12 and 2.37 ± 0.74; significant differences being noted among those with and without EPS (p < 0.001). Positive and EPS associated with dental caries with odds ratio of 5.26 (1.05, 26.2) and 8.52 (2.31, 31.4) (p < 0.001). Depressive and EPS were associated with periodontal disease with odds ratio of 4.19 (1.53, 32.5) and 5.27 (1.29, 21.5), respectively (p < 0.001). Cognitive and EPS were associated with dental prosthetic needs with odds ratio of 4.33 (1.47, 31.2) (p < 0.001) and 7.78 (1.43, 42.2), respectively (p < 0.001).

Conclusions: Patients with schizophrenia had high dental caries, periodontal disease and unmet dental prosthetic needs. Severity of the schizophrenic and EPS was associated with poor oral health. Efforts need to be focused on strengthening the evidence of its association with oral health indicators through further studies including cohort investigations.

Keywords:

• Cognitive disorders
• depressive symptoms
• extra pyramidal disorders
• oral health
• schizophrenia

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Abhinav Singh, BDS, MDS is an Assistant Professor, Public Health Dentist Specialist. His research interest includes primary health care issues, risk factors for oral diseases among social disadvantaged, marginalized and ethnic minorities and oral health policy issues.

Pankaj Mittal, MD is an Assistant Professor, Psychiatry Specialist

Pankaj Goel, BDS, MDS is a Professor, Public Health Dentist Specialist

Bharathi M. Purohit, BDS, MDS is an Associate Professor, Public Health Dentist Specialist

Rishi Thukrak, BDS, MDS is a Senior Resident, Maxillo - facial surgeon