CLINICAL DEPRESSION AND PERIODONTAL TREATMENT OUTCOMES

这项拟议的研究试图确定在接受牙周治疗的人中，患有临床抑郁症的人与没有临床抑郁症的人相比，结果是否更差。成人牙周炎在人群中普遍存在，牙周状况与严重的全身疾病相关，成人牙周炎的治疗费用高昂，现有的治疗方式效果各不相同。抑郁症很可能在决定牙周治疗结果中起着重要作用。将使用俄勒冈州波特兰市凯撒-永久牙科计划(KPDCP)的牙科实践数据进行一项回溯性队列研究，使我们能够解决以下研究问题：L)临床抑郁症是否会增加牙周治疗结果不良的风险？2)临床抑郁症(包括精神药物)的治疗是否会减少观察到的抑郁状态对牙周治疗结果的负面影响？3)临床抑郁症的共病(焦虑、酗酒和药物滥用、恐慌症、强迫症)是否会增加临床抑郁症对牙周治疗结果的负面影响？这项提案首次调查了临床抑郁症对牙周结局的影响。将收集和分析抑郁症状况、合并症、抑郁症治疗、社会人口学、药物和其他潜在混杂因素以及牙周治疗结果的指标。对110例抑郁症患者和等量的非抑郁症患者进行了L年的牙周治疗的回顾性随访。牙周治疗结果将在一年后通过比较抑郁症患者和非抑郁症患者牙周袋深度等于或等于&gt；4毫米的部位比例的变化来评估。研究结果将有助于确定是否需要对临床抑郁的牙周患者进行治疗干预，从而改善牙周治疗结果。这些改变的治疗干预措施将有助于提高患有临床抑郁症的牙周患者的牙周治疗的质量、可及性和有效性。

The proposed study seeks to determine if among persons receiving periodontal treatment, those with clinical depression have poorer outcomes compared to those without clinical depression. Adult periodontitis is widespread in the population, periodontal case status has been associated with serious systemic conditions, the treatment of adult periodontitis is costly, and existing treatment modalities are of varying effectiveness. It is likely that depression plays a substantial role in determining periodontal treatment outcomes. A retrospective cohort study will be conducted using data obtained from the dental practices of Kaiser-Permanente Dental Program(KPDCP) in Portland, Oregon, allowing us to address the following research questions: l) Does clinical depression increase the risk of poor periodontal treatment outcomes? 2) Does treatment for clinical depression (including psychotropic medications) reduce the observed negative effect of depression status on periodontal treatment outcomes? 3) Do comorbidities of clinical depression(anxiety, alcohol and drug abuse, panic disorder, obsessive-compulsive disorder) increase the observed negative effect of clinical depression on periodontal treatment outcomes? This proposal investigates the effect of clinical depression on periodontal outcomes for the first time. Measures of depression status, comorbidities, treatment for depression, sociodemographics, medications and other potential confounders, and outcome of periodontal treatment will be collected and analyzed. 110 patients with depression and an equal number of non-depressed patients will be retrospectively followed for a period of l year during which time they underwent periodontal treatment. Periodontal treatment outcome will be assessed at the one year-follow-up by comparing the change in proportion of sites with pocketing equal to or > 4 millimeters in depth for depressed and non-depressed patients. Results of the study will be useful in determining the need for altered therapeutic intervention for clinically depressed periodontal patients, so as to improve the outcomes of periodontal treatment. These altered therapeutic interventions will serve to improve the quality, accessibility, and effectiveness of periodontal treatment for the population of periodontal patients suffering from clinical depression.