Association Between Anxiety, Depression, and Salivary Cortisol Levels in Patients with Recurrent Aphthous Stomatitis

Objective: Recurrent aphthous stomatitis (RAS) is the most common ulcerative disease of the oral mucosa that commonly affects the general population. The objective of this study was to conduct a research in assesing the relationship between psychological disorders including anxiety, depression and salivary cortisol levels in patients with RAS. Methods: Thirty-nine patients suffering from minor RAS were enrolled in the study after obtaining an informed consent. The control group consisted of 25 age and gender matched healthy individuals. All subjects were evaluated by using both psychological tests (Hamilton's anxiety rating scale [HARS] and Hamilton's depression rating scale [HDRS]) and physiological testing instrument (salivary cortisol level). Results: While no statistical difference was found between the patients with RAS and controls for both salivary cortisol levels and anxiety, there was statisticaly significant difference between the groups for depression. Conclusion: There was no significant increase in salivary cortisol levels in patients with active disease when compared to the healthy subjects. But we found that depression scale values were significantly higher in patients with RAS.