Risk of anxiety and depression in patients with lichen planus: A nationwide population-based study.

BACKGROUND: This study aims to determine the risk of developing anxiety and/or depression among patients with lichen planus. METHODS: Based on the Longitudinal Health Insurance Database of Taiwan National Health Insurance Research Database, a total of 4012 patients with lichen planus and 16,048 matched controls (1:4) were enrolled between January 1, 2000, and December 31, 2015. After controlling for the risk variables, multivariate Cox proportional hazard regression and the log-rank test with Kaplan-Meier method were performed to assess the influence of anxiety/depression among individuals with lichen planus under a maximum follow-up period of 16 years. RESULTS: The subsequent anxiety or depression incidence of the lichen planus group and the comparisons was 19.67% (1962.70 per 105 person-years) and 10.11% (982.23 per 105person-years), respectively. Additionally, after adjustment of the risk variables, the hazard ratios for anxiety, depression, anxiety without depression, depression without anxiety, anxiety or depression, and both anxiety and depression combined were 1.779 (95%CI: 1.289-2.477, p < 0.001), 2.010 (95%CI: 1.454-2.790, p < 0.001), 2.015 (95%CI: 1.463-2.799, p < 0.001), 2.356 (95%CI: 1.705-3.286, p < 0.001), 2.011 (95%CI: 1.457-2.793, p < 0.001), and 1.515 (95%CI: 1.100-2.134, p < 0.001), respectively. LIMITATIONS: Individuals with lichen planus were unable to be classified into oral subtype and cutaneous subtype based on the ICD-9-CM. Moreover, the results of our study could not demonstrate the mechanism between lichen planus and anxiety and/or depression. CONCLUSION: Patients with lichen planus was positively associated with developing anxiety or depression. Physicians should to be aware of the signs of anxiety and/or depression while facing the patients with lichen planus during the clinical practices.

Risk of depression in patients with oral cancer: a nationwide cohort study in Taiwan.

This study investigates an association between oral cancers and the risk of developing depression. We conducted a total of 3031 patients with newly diagnosed oral cancers and 9093 age-, sex-, and index year-matched controls (1:3) from 2000 to 2013 were selected from the National Health Insurance Research Database (NHIRD) of Taiwan. After adjusting for confounding factors, multivariate Cox proportional hazards analysis was used to compare the risk of depression over a 13-year follow-up. Of the patients with oral cancer, 69 (2.28%, or 288.57 per 105 person-years) developed depression compared to 150 (1.65%, 135.64 per 105 person-years) in the control group. The Cox proportional hazards regression analysis showed that the adjustment hazard ratio (HR) for subsequent depression in patients with oral cancer diagnosed was 2.224 (95% Confidence Interval [CI] 1.641-3.013, p < 0.001). It is noteworthy that in the sensitivity analysis is the adjusted HR in the group with depression diagnosis was 3.392 and in the oral cancer subgroup of "Tongue" was 2.539. This study shows oral cancer was associated with a significantly increased risk for developing subsequent depression and early identification and treatment of depression in oral cancer patients is crucial.

The association of betel quid, alcohol, and cigarettes with salivary gland tumor-A case-control study.

BACKGROUND/PURPOSE: Salivary gland tumor (SGT) is a rare disease with a largely unknown etiology. The risks of betel quid chewing, alcohol drinking, and cigarette smoking have been well documented in oral cancer but not in SGT. We aimed to investigate the independent and combined effects of betel quid chewing, cigarette smoking, and alcohol consumption on the incidence of SGT. MATERIALS AND METHODS: We conducted a case-control study of 1845 patients aged 35-65 years, including 239 patients with pathologically proven SGT and 1606 controls from the health examination clinics of the same hospital during 2005-2014 to examine the association of these three risk factors with SGT in Taiwan. Adjusted odds ratio (aOR) and their 95% confidence interval for the association of risk factors to SGT were analyzed. RESULTS: After adjusting for covariates, aOR of cigarette smoking, alcohol drinking, and betel quid chewing were 2.50, 1.27, and 3.38, respectively for SGT. The significantly increased risk for SGT was observed in cigarette smoking (P < 0.001). Cigarette smoking was also found to increase risks in subgroups of SGT (aOR = 5.24, 2.41, 2.63, and 2.04 in minor, major, benign, and malignant SGT, respectively). CONCLUSION: Our study provided the first evidence to show the independent and combined impact of betel quid chewing with cigarette smoking and alcohol drinking on the SGT, and support the concept that cigarette smoking may associate with SGT carcinogenesis.