CLINICAL DEPRESSION AND PERIODONTAL TREATMENT OUTCOMES

这项拟议中的研究旨在确定在接受牙周治疗的人中，与没有临床抑郁症的人相比，临床抑郁症患者的结果是否更差。 成人牙周炎在人群中很普遍，牙周病的状况与严重的全身性疾病有关，成人牙周炎的治疗费用很高，现有的治疗方法效果不一。抑郁症可能在决定牙周治疗结果方面起着重要作用。将使用从俄勒冈州波特兰的Kaiser-Permanente牙科项目（KPDCP）的牙科实践中获得的数据进行回顾性队列研究，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效果不良的风险？2)临床抑郁症的治疗（包括精神药物）是否能减少抑郁状态对牙周治疗结果的负面影响？3)临床抑郁症的合并症（焦虑、酒精和药物滥用、恐慌症、强迫症）是否增加了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果的影响。 将收集并分析抑郁状态、合并症、抑郁治疗、社会人口统计学、药物和其他潜在混杂因素以及牙周治疗结局的指标。110例抑郁症患者和相同数量的非抑郁症患者将被回顾性随访一年，在此期间他们接受牙周治疗。将在1年随访时通过比较抑郁和非抑郁患者中袋状凹陷深度等于或> 4 mm的部位比例变化来评估牙周病治疗结局。研究结果将有助于确定临床抑郁症患者是否需要改变治疗干预，以改善牙周治疗的结果。 这些改变的治疗干预措施将有助于提高牙周治疗的质量，可及性和有效性的牙周病患者患有临床抑郁症的人口。

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.