Interrelationships Among Psychological Conditions, Oral Health-related Quality of Life, and Clinical Characteristics in Chinese Patients with Minor Recurrent Aphthous Stomatitis

Aims: Recurrent aphthous stomatitis (RAS) is a common chronic inflammatory oral mucosal disorder with uncertain aetiology. This study aimed to investigate the psychological conditions (ie, depression, anxiety and stress) and oral health-related quality of life (OHRQoL) profiles in Chinese Minor RAS (MiRAS) patients. It also sought to explore the relationships between psychological status and OHRQoL and to identify the impact of clinical characteristics of MiRAS on them. Methods: The descriptive cross-sectional study was conducted using a non-random consecutive sampling method. All recruited participants completed a set of uniform anonymous questionnaires that included basic demographics, the Chinese version of the Depression, Anxiety, Stress Scales-21 (DASS-21) and the 14-item Oral Health Impact Profile (OHIP-14). Additionally, the clinical characteristics were also recorded through face-to-face interviews. Data were statistically analysed using independent sample T test, Mann–Whitney U test, Pearson’s Chi-square test, Spearman rank-order correlation analysis, and logistic regression analysis, with the significance level set at P < .05. Results: A total of 264 eligible volunteers participated in this study with a median age of 25.0 years (44.70% women), consisting of 106 Chinese MiRAS patients and 158 healthy controls. In contrast to healthy participants, MiRAS patients exhibited statistically higher levels of psychological distress and poorer OHRQoL. Strong positive interrelationships were observed between total DASS-21, depression, anxiety and stress subscale in MiRAS patients. However, total OHIP-14 was weakly positively correlated with total DASS-21 and its three subscales among all participants. Logistic regression analyses revealed that lesion duration was the sole risk factor for depression, anxiety, and stress. Additionally, higher pain intensity and increased frequency of episodes may statistically reduce the perceived OHRQoL of MiRAS patients. Conclusion: Longer lesion duration may increase psychological distress, while recurrent episodes of painful ulcerations may cause inferior QoL. Additionally, appropriate psychological counselling and psychotherapy may improve patient’s QoL.