{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:20:15Z","timestamp":1787772015587,"version":"build-2784847793"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The most prevalent oral mucosal conditions in humans are leukoplakia, oral lichen planus (OLP), and oral submucous fibrosis (OSMF). These conditions should be studied as psychosomatic conditions, but little research has been done on how these conditions relate to stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 280 patients of both genders with ages 35\u201360 years were divided into four groups: leukoplakia, OSMF, OLP, and control. Whole blood samples were collected from all the participants and analyzed for serum cortisol by using ELISA with a commercial kit. Detailed case history and DASS-21 questionnaire were recorded for psychological assessment. To assess the variables, the student\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      test and Chi-square test were used.\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      values of &lt;0.05 were regarded as significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In this study, it was found that higher levels of serum cortisol were found in OLP patients, with advanced erosive lesions showing the highest levels of serum cortisol, followed by OSMF and leukoplakia. Patients with Oral Lichen Planus showed higher levels of stress, anxiety and depression than patients of OSMF and leukoplakia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study emphasized stress and anxiety as a predisposing factor in the occurrence and progression of OSMF apart from re-establishing the role of stress and anxiety in OLP with consideration to depression in triggering role for OLP. Furthermore, it demonstrated that serum cortisol levels play a significant role as an indicator of psychological stress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jpbs.jpbs_1267_23","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:14Z","timestamp":1709769614000},"page":"S2021-S2023","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["A Study to Assess the Role of Psychological Stress in the Severity of Oral Lichen Planus, OSMF, and Leukoplakia and its Correlation with Serum Cortisol Levels"],"prefix":"10.4103","volume":"16","author":[{"given":"Saba","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Oral Medicine and Radiology (Ph. D. Scholar), Narshinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhaval N.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Radiology (Ph. D. Guide), Narshinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Radiology, Darshan Dental College and Hospital, Loyara, Udaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Somani","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Radiology, Darshan Dental College and Hospital, Loyara, Udaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Pathan","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helly","family":"Thakkar","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Radiology, Darshan Dental College and Hospital, Loyara, Udaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swati","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Radiology, Darshan Dental College and Hospital, Loyara, Udaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"R1-20240829","first-page":"40291","article-title":"Depression and its effect on oral health \u2013A review","volume":"11","author":"Durne","year":"2020","journal-title":"Int J Recent Sci Res"},{"key":"R2-20240829","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.21474\/IJAR01\/1892","article-title":"Stress evaluation using DAS scale and 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