Oral health-related quality of life status and risk factors in patients with mental disorders

doi:10.7518/hxkq.2025.2024256

Abstract

Abstract:

Objective This study aims to explore the current status and risk factors of oral health-related quality of life OHRQoL in patients with mental disorders and provide evidence for effective intervention measures. Methods A total of 397 patients diagnosed with mental illness were selected by convenience sampling, and investigation was carried out using general data questionnaire, health literacy in dentistry-14 (HeLD-14), oral health impact profile-14 (OHIP-14), and oral health status checklist. Results The total score of OHIP-14 in patients with mental disorders was 8(2, 14). The score of HeLD-14 was negatively correlated with the score of OHIP-14 (r=-0.142, P<0.01). The results of multiple linear regression showed that six variables including annual family income, schizophrenia, sweets, frequency of visits to the dentist, dental caries, and missing teeth affected OHRQoL of patients with mental disorders (P<0.05). Conclusion The poor OHRQoL of psychiatric patients is associated with many factors. Medical personnel should pay attention to their oral health problems and develop targeted oral care programs throughout the course of disease to improve oral health and related quality of life of patients.

Key words: mental disorders, oral health, health literacy, quality of life, risk factor

CLC Number:

R780.1

Yang Xuemei, Wang Hongyu, Tang Yonghua, Yin Chengjun, Yu Jingya, Bi Xiaoqin. Oral health-related quality of life status and risk factors in patients with mental disorders[J]. West China Journal of Stomatology, 2025, 43(1): 84-91.

Figures/Tables 6

Tab 1

Tab 2

Effects of patients’ basic information and oral health behavior on OHRQoL in patients with mental disorders

因素		n/%	OHIP-14得分	Z值	$χ 2$ 值	P值
年龄/岁	≤18	4/1.0	16.5（4.0，26.8）	-	9.862	0.020^*
	18~35	49/12.3	2.0（0.5，13.0）
	35~60	250/63.0	8.0（2.0，14.0）
	>60	94/23.7	8.0（3.8，15.0）
性别	男	235/59.2	8.0（2.0，14.0）	-0.724	-	0.469
	女	162/40.8	6.0（2.0，14.0）
受教育程度	小学及以下	164/41.3	8.5（3.0，14.0）	-	4.472	0.346
	初中	138/34.8	7.0（2.0，14.0）
	高中	66/16.6	5.5（1.0，14.3）
	大专及本科	28/7.1	5.0（1.0，14.0）
	硕士及以上	1/0.3	1.0
家庭年收入/万	≤3	167/42.1	8.0（2.0，14.0）	-	22.258	0.000^*
	3~8	150/37.8	9.0（2.0，14.0）
	8~15	54/13.6	5.0（1.0，12.3）
	15~30	21/5.3	2.0（1.0，6.0）
	>30	5/1.3	0（0，1.0）
医疗支付方式	自费	20/5.0	14.0（6.5，16.5）	-2.232	-	0.026^*
	医疗保险	377/95.0	7.0（2.0，14.0）
合并慢性病	高血压	37/9.3	7.0（1.0，15.5）	-	0.199	0.655
	糖尿病	41/10.3	8.0（4.5，14.0）
	其他慢性病	166/41.8	9.0（2.0，14.0）
	无合并症	153/38.5	5.0（1.0，13.0）
精神障碍诊断	精神分裂症	252/63.5	9.0（3.0，14.0）	-	12.662	0.027^*
	抑郁症	35/8.8	4.0（1.0，8.0）
	躁狂症	2/0.5	6.5（1.0，12.0）
	焦虑症	34/8.6	2.0（1.0，13.3）
	双相情感障碍	12/3.0	8.5（1.3，17.8）
	其他	62/15.6	7.5（1.8，14.3）
精神障碍病程/年	≤1	6/1.5	2.0（0，33.0）	-	11.692	0.009^*
	1~5	113/28.5	4.0（1.0，12.0）
	5~10	71/17.9	9.0（2.0，15.0）
	>10	207/52.1	9.0（3.0，14.0）
服用抗精神病类药物	是	376/94.7	8.0（2.0，14.0）	-0.017	-	0.987
	否	21/5.3	6.0（1.5，15.0）
吸烟	是	162/40.8	8.0（1.8，14.0）	-0.392	-	0.695
	否	235/59.2	7.0（2.0，14.0）
饮酒	是	67/16.9	7.0（1.0，15.0）	-0.073	-	0.942
	否	330/83.1	8.0（2.0，14.0）
甜食	是	240/60.5	6.0（1.0，14.0）	-2.769	-	0.006^*
	否	157/39.5	9.0（3.0，15.0）
刷牙频率/（次/d）	<2	232/58.4	8.5（3.0，14.0）	-2.292	-	0.022^*
	≥2	165/41.6	6.0（1.0，14.0）
刷牙持续时间/（min/次）	<2	273/68.8	9.0（2.0，14.0）	-3.208	-	0.001^*
	≥2	124/31.2	5.0（1.0，13.0）
看牙医频次/（次/年）	<2	374/94.2	7.0（2.0，14.0）	-3.631	-	0.000^*
	≥2	23/5.8	16.0（8.0，20.0）
口腔健康状况自评	好	67/16.9	4.0（1.0，13.0）	-	11.016	0.004^*
	一般	209/52.6	7.0（2.0，14.0）
	差	121/30.5	9.0（4.0，14.0）

Tab 2

Tab 3

Effects of different oral health status on OHRQoL in patients with mental disorders

因素		n/%	OHIP-14得分	Z值	$χ 2$ 值	P值
缺牙	有	189/47.6	10.0（4.0，15.0）	-4.385	-	0.000^*
	无	208/52.4	5.0（1.0，13.8）
龋齿	有	181/45.6	8.0（3.0，16.0）	-3.431	-	0.001^*
	无	216/54.4	6.5（1.0，14.0）
牙龈出血	有	164/41.3	8.0（4.0，15.0）	-3.322	-	0.001^*
	无	233/58.7	7.0（1.0，14.0）
牙结石	有	346/87.2	7.5（2.0，14.0）	-0.29	-	0.772
	无	51/12.8	8.0（1.0，14.0）
牙周红肿/溢脓	有	51/12.8	8.0（4.0，17.0）	-1.962	-	0.050^*
	无	346/87.2	7.0（2.0，14.0）

Tab 3

Tab 4

Tab 5

Tab 6

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项目	最大值	M（P₂₅，P₇₅）
功能受限	8	2（0，3）
疼痛与不适	8	3（1，4）
心理不适	9	1（0，3）
独立能力减弱	16	1（0，5）
OHIP-14总分	35	8（2，14）

HeLD-14	OHIP-14
HeLD-14	功能受限	疼痛与不适	心理不适	独立能力减弱	总分
关注	-0.051	-0.059	-0.148^**	-0.244^**	-0.125^*
理解	-0.102^*	-0.069	-0.177^**	-0.232^**	-0.153^**
支持	-0.093	-0.070	-0.180^**	-0.254^**	-0.148^**
经济负担	-0.051	-0.043	-0.094	-0.161^**	-0.084
就医	-0.065	-0.050	-0.148^**	-0.221^**	-0.119^*
沟通	-0.055	-0.043	-0.169^**	-0.240^**	-0.125^*
应用	-0.027	-0.017	-0.154^**	-0.235^**	-0.103^*
总分	-0.074	-0.062	-0.174^**	-0.256^**	-0.142^**

变量名	赋值
年龄	≤18岁=1，18~35岁=2，35~60岁=3，>60岁=4
家庭年收入	≤3万=1，3~8万=2，8~15万=3，15~30万=4，>30万=5
医疗支付方式	自费=1，医疗保险=0
精神障碍诊断	1）精神分裂症=0，抑郁症=1，躁狂症=0，焦虑症=0，双相情感障碍=0，其他=0 2）精神分裂症=0，抑郁症=0，躁狂症=1，焦虑症=0，双相情感障碍=0，其他=0 3）精神分裂症=0，抑郁症=0，躁狂症=0，焦虑症=1，双相情感障碍=0，其他=0 4）精神分裂症=0，抑郁症=0，躁狂症=0，焦虑症=0，双相情感障碍=1，其他=0 5）精神分裂症=0，抑郁症=0，躁狂症=0，焦虑症=0，双相情感障碍=0，其他=1
精神障碍病程	≤1年=1，1~5年=2，5~10年=3，>10年=4
甜食	是=1，否=0
刷牙频率	<2次/d=1，≥2次/d=0
刷牙持续时间	<2 min/次=1，≥2 min/次=0
看牙医频次	<2次/年=1，≥2次/年=0
口腔健康状况自评	好=1，一般=2，差=3
缺牙	有=1，无=0
龋齿	有=1，无=0
牙龈出血	有=1，无=0
牙周红肿/溢脓	有=1，无=0
HeLD-14总分	以原始数值录入

项目	非标准化系数		标准化系数	t值	P值	共线性诊断
项目	B值	标准误	β值	t值	P值	VIF	容忍度
常数	18.149	6.075		2.987	0.003^**
家庭年收入	-1.614	0.440	-0.198	-3.666	0.000^**	1.370	0.730
诊断为精神分裂症	-3.200	1.422	-0.120	-2.251	0.025^*	1.333	0.750
甜食	2.231	0.777	0.144	2.871	0.004^**	1.183	0.845
看牙医频次	5.842	1.624	0.180	3.597	0.000^**	1.180	0.847
缺牙	-1.652	0.795	-0.109	-2.076	0.039^*	1.294	0.773
龋齿	-2.528	0.778	-0.166	-3.250	0.001^**	1.231	0.812
R²值	0.196
调整R²值	0.156
F值/P值	4.846/0.000^**
D-W值	1.46

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