{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:29:15Z","timestamp":1786422555840,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined associations between psychological factors, serum zinc\/iron levels, and clinical features of factitious oral ulcers in children (3\u201316\u2009years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional analysis of 69 patients (78.3% male) from two Chinese hospitals assessed ulcer characteristics, pain (VAS), micronutrient levels, and psychological scores (SCARED, DSRSC, CPRS, SDQ). Statistical analysis used nonparametric tests and correlation analysis (SPSS 26.0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Zinc deficiency (37.7%) correlated with longer disease duration (12.0 vs. 6.0\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035) and shorter ulcer\u2010free intervals (60.0 vs. 95.2\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040). Zinc levels inversely linked to emotional symptoms (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.416,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022) but positively to prosocial behavior (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.526,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Pain intensity associated with anxiety (VAS: 4.0 vs. 3.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025) and psychosocial distress (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.461,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010). Older children (8\u201316\u2009years) had longer disease duration (12.0 vs. 3.6\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and higher zinc deficiency (47.5% vs. 24.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). Iron showed paradoxical associations with emotional symptoms (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.452,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012) and prosocial behavior (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.382,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Zinc deficiency and psychological factors critically influence the chronicity of FOU. Multidisciplinary care combining micronutrient supplementation and behavioral interventions is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70228","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T06:30:31Z","timestamp":1770013831000},"page":"1619-1630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychological Factors, Serum Trace Elements, and Clinical Features of Factitious Oral Ulcers in Children and Adolescents: A Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2461-2150","authenticated-orcid":false,"given":"Ling","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Stomatology, Core Unit of National Clinical Research Center for Oral Diseases Xinhua Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai 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Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxiang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine The Affiliated Stomatological Hospital of Guilin Medical University  Guilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1150-5613","authenticated-orcid":false,"given":"Guoyao","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Core Unit of National Clinical Research Center for Oral Diseases Xinhua Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai 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