RAS and Depression: Is there an Association?

Recurrent aphthous stomatitis (RAS) is a condition characterized by recurrent and painful intraoral ulcers. Certain psychological factors may trigger RAS onset. However, the association between depression and RAS has not been fully investigated.

Objectives: Determine whether depression and idiopathic RAS are associated.

Methods: We conducted an unmatched case-control study at the University of Florida (June 2006-August 2007). Data were collected through questionnaires and oral examinations. We analyzed past history of depression lasting over 2 months (DE; yes/no) in cases (ever has RAS) and controls (never had RAS) and depression levels in the past 7 days (DW; 0-10 scale) in active (RAS on examination) and inactive (RAS in past 6-12 months) cases. Data were analyzed using crude odds ratios (OR; 95% CI), Mantel-Haenszel chi-square test with rank scores, two-sided alpha=0.05 and SAS v9.1.

Results: A total of 234 participants were screened, 12 were excluded, 25 withdrew, and 197 completed the study (123 cases, 74 controls). Age range was 17-66 years (mean 25 years for both groups), 56% females, 14% Hispanic, 63% White, 17% Asian, 11% Black and 9% other/mixed race. Over 20% of cases reported DE vs. 15% controls (OR = 1.46, CI= 0.67-3.18; p-value= 0.34). Mean DW among inactive cases (n=13) was 1.38 (median=0) whereas in active cases (n=16) mean DW was 1.37 (median=1; p-value= 0.19).

Conclusion: There was no difference in history of depression in cases vs. controls or in active vs. inactive cases. The lack of association between depression and RAS does not support a substantial role of depression in RAS etiology or onset.

NIH support R03DE016356, 5U24DE016509, and M01RR00082