CLINICAL DEPRESSION AND PERIODONTAL TREATMENT OUTCOMES

这项拟议的研究旨在确定在接受牙周治疗的人群中，那些有临床抑郁症的人是否比没有临床抑郁症的人有更差的结果。成人牙周炎在人群中广泛存在，牙周病例状况与严重的全身性疾病有关，成人牙周炎的治疗费用昂贵，现有的治疗方式效果不一。抑郁症很可能在决定牙周治疗结果方面起着重要作用。一项回顾性队列研究将使用来自俄勒冈州波特兰Kaiser-Permanente牙科计划（KPDCP）牙科实践的数据进行，使我们能够解决以下研究问题：1)临床抑郁症是否会增加不良牙周治疗结果的风险？2)临床抑郁症治疗（包括精神药物治疗）是否能减少观察到的抑郁症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）是否会增加临床抑郁症对牙周治疗结果的负面影响？本研究首次探讨临床抑郁对牙周预后的影响。将收集和分析抑郁状态、合并症、抑郁治疗、社会人口统计学、药物和其他潜在的混杂因素以及牙周治疗的结果。110名抑郁症患者和同等数量的非抑郁症患者将进行为期一年的回顾性随访，在此期间，他们接受了牙周治疗。牙周治疗的结果将在一年的随访中通过比较抑郁症和非抑郁症患者的口袋深度等于或等于0.4毫米的部位比例的变化来评估。研究结果将有助于确定临床上牙周抑郁患者是否需要改变治疗干预措施，从而改善牙周治疗的结果。这些改变的治疗干预措施将有助于改善牙周治疗的质量、可及性和有效性，以治疗患有临床抑郁症的牙周患者。

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.