Association of salivary cortisol and psychological burden in patients with oral cancer and oral potentially malignant disorders: A prospective study.

INTRODUCTION: This study aimed to find an association between psychological burden (in terms of depression, anxiety, and stress) and salivary cortisol among oral cancer (OC) and oral potentially malignant disorder (OPMD) patients at various time frames. METHODS: In total, 50 patients with OC and OPMD were studied after their informed consent along with 30 healthy controls. Depression, anxiety, and stress scale-21 (DASS-21) was administered and saliva was collected (non-invasively) at different stages including the time of diagnosis, one and three months after intervention (medical or surgical). To avoid diurnal variation, saliva was collected twice (morning and evening). To assess the linear relationship between depression, anxiety, and stress with salivary cortisol, a partial correlation was calculated. RESULTS: Comparison of salivary cortisol levels among control, OC, and OPMD groups showed a statistically significant difference in both morning and evening values at different point of time intervals. Higher values of salivary cortisol were observed in OC patients (both morning and evening) in comparison to the OPMD or control group. A positive correlation was discerned between stress and salivary cortisol in both OPMD and OC patients, while no association was found for depression and anxiety domains. CONCLUSION: The measurement of salivary cortisol effectively demonstrates raised stress levels in OPMD as well as OC patients. Therefore, it is recommended to institute stress management interventions in the patients as part of the treatment of OPMD and OC.