Sociodemographic risk indicators for depressive symptoms among persons with oral cancer or oral epithelial dysplasia

Sociodemographic risk indicators for depressive symptoms among persons with oral cancer or oral epithelial dysplasia
April 2005
Susan Reisine, PhD⁎, Douglas E. Morse, DDS, PhD‹, Walter J. Psoter, DDS, PhD·, Ellen Eisenberg, DMD?, Donald Cohen, DMD, MS∥, Deborah Cleveland, DDS?, Mirseyed Mohit-Tabatabai, MD#
Journal of Oral & Maxillofacial Surgery

Purpose
We report findings from a study that measured associations between sociodemographic risk indicators and depressive symptoms among individuals diagnosed with either oral cancer or a premalignant lesion.

Materials and methods
Incident cases of oral cancer and oral epithelial dysplasia (OED) were identified by reviewing pathology reports generated by 3 oral pathology laboratories serving primarily community-based oral and maxillofacial surgeons. Subjects were interviewed by telephone to collect information on sociodemographic characteristics, depressive symptoms using the Center for Epidemiologic Studies-Depression (CES-D) Scale, and social support using the Berkman Social Network Inventory.

Results
The analysis included 167 oral cancer and 234 OED cases. Nineteen percent of the subjects had a CES-D score indicative of clinical depression (CES-D ≥16). Forward and backward stepwise logistic regression identified diagnosis (cancer/OED), age, social support, employment status, and gender as sociodemographic indicators of CES-D scores of 16+. In the final model, which also controlled for smoking and drinking, the odds of having elevated CES-D scores (16+) were 79% higher among oral cancer relative to OED cases. The odds of high CES-D scores were significantly reduced in persons over the age of 50 compared with those aged 50 years and younger as well as in persons with higher, relative to low, levels of social support and in persons employed outside the home compared with those who were not. Although not statistically significant, men were more likely to have CES-D scores indicative of clinical depression.

Conclusions
Knowledge of sociodemographic characteristics may assist the clinician in identifying those individuals with an elevated risk of concomitant depressive symptoms.

⁎ Professor and Head, Department of Behavioral Sciences, University of Connecticut School of Dental Medicine, Farmington, CT

‹ Associate Professor, Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, NY

· Assistant Professor, University of Puerto Rico School of Dentistry, San Juan, Puerto Rico; Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, NY

? Professor, University of Connecticut School of Dental Medicine, Department of Oral Diagnosis, Farmington, CT

∥ Professor and Section Head, Oral Pathology, Department of Oral and Maxillofacial Surgery and Diagnostic Services, University of Florida College of Dentistry, Gainesville, FL

? Associate Professor, Director of Oral Pathology, Diagnostic Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ

# Chief of Surgical Oncology, Department of VeteranÌs Affairs, New Jersey Health Care System, South Orange, NJ

Address correspondence and reprint requests to Dr Reisine: Department of Behavioral Sciences MC3910, University of Connecticut School of Dental Medicine, 263 Farmington Ave, Farmington, CT 06030-3910

This work was supported by grant NIH/NIDCR P50 DE10592 and NIH/NIDCR U54 DE14257.

PII: S0278-2391(04)01632-5

doi:10.1016/j.joms.2004.12.006

© 2005 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Copyright © 2007 Elsevier, Inc. All rights reserved

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