Assessment and correlation of anxiety, depression and serum cortisol levels in patients with oral submucous fibrosis and leukoplakia: A clinicohematological study

Context: Potentially malignant disorders (PMDs) of the oral cavity like oral submucous fibrosis (OSMF) and leukoplakia are known to be caused due to addictive habits, while serum cortisol is accepted to be a stress hormone. Aim: The present study was aimed to assess and correlate the anxiety, depression and serum cortisol levels in habit-associated PMDs such as OSMF and leukoplakia and compare it with healthy subjects. Materials and Methods: Ninety patients were included in the study and were divided into three Groups, namely Group I (OSMF), Group II (leukoplakia) and Group III (control group). Serum cortisol levels and severity of anxiety and depression using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were recorded and correlated. Results: A significant correlation existed between serum cortisol level and levels of both anxiety and depression between Group I and II as compared to the control group. Conclusion: There exists a definite correlation between serum cortisol levels and the levels of anxiety and depression in patients with leukoplakia and OSMF, with increasing levels of serum cortisol and higher values in both the HAM-A and HAM-D scales in patients with both OSMF and leukoplakia. PMDs such as leukoplakia and OSMF have an established cancer-causing potential. Anxiety and depression although prevalent are underdiagnosed and poorly understood. Hence, a holistic approach in the treatment of such pathologies including hematological investigations and psychological evaluation should be mandatorily made a part of the workup and treatment plan.