神经系统疾病

Background:

Oral health is an essential part of general health. There is proving that patients suffering from mental illness are more vulnerable to dental neglect and poor oral health. Orodental diseases seem to be poorly recognized by psychiatrists, and oral health is no exception. Psychiatric disorders affect the general behavior of a person, impair the level of functioning, and alter perception toward oral health. Eating and sleeping patterns take precedence over personal hygiene, making them susceptible to many oral diseases. The two diseases that have a major impact on the oral cavity are dental caries (tooth decay) and periodontal disease (gum disease).

Patients & Methods:

This is a study of dental diseases in psychiatric patient’s comorbidity in Abha Psychiatric Hospital in Aseer region that is located at the southern area of Saudi Arabia, which is a high-altitude area of about 2500–3000 m above sea level. A written concent is obtained from every patients or first degree relatives in case of children. This study included all patients attending the Abha Psychiatric Hospital, which served a population of about 2 million persons during the period of 1 Hijri year of 1437. Data of all patients in the hospital during this year were reviewed, including age, sex, nationality, inpatient, or OPD patient. This hospital is the only governmental hospital with OPD and inpatient departments serving the area together, with some private hospitals and polyclinics giving outpatient service only.

The hospital consists of seven OPD clinics for adult psychiatric services working 4 days per week, and another OPD clinic for child and adolescent psychiatry and nine inpatient wards with 117 beds, including acute male psychiatric ward with 13 beds, acute male addiction ward with 15 beds, sub-acute psychiatric ward with 15 beds, sub-acute addiction ward with 15 beds, rehabilitation male ward with 15 beds, male chronic patients ward with 15 beds, jail ward with four beds, acute female ward with 10 beds, and sub-acute female ward with 10 beds. There are two more emergency room clinics working daily for 24 h with five beds for patient observation and for those patients waiting for admission, and there is a dental clinic operated by two dental specialist physicians working on a daily basis and serving all patients including OPD patients by direct referral from psychiatrists and inpatients by direct referral from their treating psychiatric doctors.

The data of all patients attending the dental clinic are registered through computer system in every OPD or admission office and then collected by the medical counting department.

Results:

Male patients were more in number compared with female patients (444 vs. 110). In addition, the age group between 25 and 45 years was more affected by dental problems than other groups. Also, the chronic psychiatric patients with a long stay at the psychiatric hospital were more affected than the newly admitted ones.

Discussion:

Mouth health is an integral part of general health, and it affects all aspects of life: personal, social and psychological. This is particularly important in patients with special needs, such as psychiatric patients. These patients have a tendency to be more prone to develop bucco-dental diseases, because of their lack of motivation, the difficulty to perform a proper mouth health technique, the hurdles that have to be overcome to treat them dentally, and the negative effects caused by psychotropic medications, affecting the normal physiology of salivary glands and epithelia of the oral mucous, causing xerostomy or sialorrhea. Different authors have reported that patients with mental illnesses get inadequate dental care because of ignorance, fear, stigmas, or negative attitudes by the professionals.