STRESS EVALUATION USING DAS SCALE AND SALIVARY CORTISOL IN PATIENTS WITH ORAL LICHEN PLANUS, ORAL SUBMUCOUS FIBROSIS, LEUKOPLAKIA AND SQUAMOUS CELL CARCINOMA.

Aim:- the aim of this observational study is to evaluate stress using das scale and salivary cortisol in patients with oral lichen planus(OLP), oral submucous fibrosis(OSMF), leukoplakia and squamous cell carcinoma(SCC). Method:- A total of 100 patients were included among which 25 subjects were taken into each group. Saliva was collected from all the subjects between 9.00 to 10.00 am to avoid diurnal variation of cortisol levels. The saliva samples were analysed for cortisol levels enzyme linked immunosorbent assay (ELISA) method. Stress, anxiety and depression levels of 100 patients were measured using DASScale. Stress, anxiety and depression among each group was analysed by Chi-square test. Stress, anxiety and depression among each group was compared by salivary cortisol levels in OSMF, Leukoplakia, Lichen planus and Squamous cell carcinoma group by Post-hoc test. Result:- The mean salivary cortisol level in OLP and SCC group showed highly significant difference when compared to OSMF and leukoplakia. The mean stress, anxiety and depression of OLP and SCC showed highly significant difference when compared to OSMF and leukoplakia. A positive correlation was found between stress, anxiety and depression and salivary cortisol levels in OLP and SCC when compared to OSMF and leukoplakia which showed negative correlation. Conclusion:- These findings suggest that stress, anxiety and depression plays an important role in pathogenesis of OLP and SCC, thus early detection of these lesion helps to improve treatment and psychiatric support for these patients.