THE ORAL-SYSTEMIC INTERFACE IN SEVERE MENTAL ILLNESS: A COMPARATIVE ANALYSIS OF DIETARY PRO-OXIDANT PATTERNS AND BIO-CLINICAL INTERSECTIONS IN PATIENTS WITH SCHIZOPHRENIA
DOI:
https://doi.org/10.22551/Abstract
This study aims to investigate the nutritional pathways and lifestyle behaviors that bridge psychiatric symptomatology and oral pathological outcomes, specifically focusing on the role of dietary-induced oxidative stress in patients with schizophrenia compared to a healthy control group. Materials and methods: A comparative cross-sectional analysis was conducted on 40 participants (20 patients with schizophrenia and 20 demographically matched controls). Nutritional habits, antioxidant intake and pro-inflammatory food frequencies were assessed using validated questionnaires. Data were statistically analyzed to identify significant divergences in consumption patterns. Results: Patients with schizophrenia showed a significantly lower intake of dietary fiber compared to controls (1.65 ± 1.51 vs. 2.80 ± 1.92, p = 0.041). Significant increases were observed in the consumption of fried foods (p = 0.029) and processed items (p = 0.048). Although antioxidant and fruit intake followed a downward trend, they did not reach the significance threshold, contributing to a documented pro-oxidant dietary environment. Conclusions: The results confirm a compromised “gut-brain-mouth” axis in schizophrenia. The dietary-induced pro-oxidant environment serves as a systemic driver for oral degradation, necessitating integrated psychiatric and dental management.
References
1. Fillman SG, Cloonan N, Miller LC, Weickert CS. Markers of inflammation in the prefrontal cortex of individuals with schizophrenia. Molecular psychiatry 2013; 18(2): 133 / doi: 10.1038/mp.2012.199.
2. Kisely S, Baghaie H, Lalloo R, Siskind D, Johnson NW. A systematic review and meta-analysis of the association between poor oral health and severe mental illness. Psychosomatic medicine 2015; 77(1): 83-92 / doi: 10.1097/PSY.0000000000000135.
3. Turner M, Jahangiri L, Ship JA. Hyposalivation, xerostomia and the complete denture: a systematic review. Journal of the American Dental Association (1939) 2008; 139(2): 146-150 / doi: 10.14219/ jada.archive.2008.0129.
4. Dipasquale S, Pariante CM, Dazzan P, Aguglia E, McGuire P, Mondelli V. The dietary pattern of patients with schizophrenia: a systematic review. Journal of psychiatric research 2013; 47(2): 197-207 / doi: 10.1016/j.jpsychires.2012.10.005
5. Remigante A, Morabito R. Cellular and Molecular Mechanisms in Oxidative Stress-Related Diseases 2.0/3.0. International journal of molecular sciences 2023; 24(21): 16018 / doi: 10.3390/ijms242116018
6. Balmus IM, Ilie OD, Ciobica A, et al. Irritable Bowel Syndrome between Molecular Approach and Clinical Expertise-Searching for Gap Fillers in the Oxidative Stress Way of Thinking. Medicina (Kaunas, Lithuania) 2020; 56(1): 38 / doi: 10.3390/medicina56010038.
7. Cojocariu R, Ciobica A, Balmus IM, et al. Antioxidant Capacity and Behavioral Relevance of a Polyphenolic Extract of Chrysanthellum americanum in a Rat Model of Irritable Bowel Syndrome. Oxidative medicine and cellular longevity 2019: 3492767 / doi: 10.1155/2019/3492767
8. Trifan A, Sfarti C, Cojocariu C, et al. Increased liver stiffness in extrahepatic cholestasis caused by choledocholithiasis. Hepatitis monthly 2011; 11(5): 372-375.
9. Trifan A, Singeap AM, Cojocariu C, Sfarti C, Stanciu C. Small bowel tumors in patients undergoing capsule endoscopy: a single center experience. JGLD 2010; 19(1): 21-25.
10. Trifan A, Stanciu C, Gheorghe L, et al. Efficacy and safety of paritaprevir / ritonavir, ombitasvir, and dasabuvir with ribavirin for the treatment of HCV genotype 1b compensated cirrhosis in patients aged 70 years or older. Medicine 2017; 96(50): e9271 / doi: 10.1097/MD.0000000000009271.
11. Yang M, Chen P, He MX, et al. Poor oral health in patients with schizophrenia: A systematic review and meta-analysis. Schizophrenia research 2018; 201: 3-9 / doi: 10.1016/j.schres.2018.04.031.
12. Aghasizadeh Sherbaf R, Kaposvári GM, Nagy K, Álmos ZP, Baráth Z, Matusovits D. Oral Health Status and Factors Related to Oral Health in Patients with Schizophrenia: A Matched Case-Control Observational Study. J Clin Med 2024; 13(6):1584 / doi:10.3390/jcm13061584.
13. Vetrani C, DE Simone G, Saia V, et al. Diet quality in patients with treatment-resistant schizophrenia: time for improving nutritional recommendations. Minerva endocrinology 2025; 50(4): 377-386 / doi: 10.23736/S2724-6507.24.04158-7.
14. Marder SR, Essock, SM, Miller AL, et al. Physical health monitoring of patients with schizophrenia. The American journal of psychiatry 2004; 161(8): 1334-1349 / doi: 10.1176/appi.ajp.161.8.1334.
15. Irie M, Asami S, Nagata S, Miyata M, Kasai H. Relationships between perceived workload, stress and oxidative DNA damage. International archives of occupational and environmental health 2001; 74(2): 153-157 / doi: 10.1007/s004200000209.
16. Comparelli A, Stampatore L, Costacurta M, Pompili M. Schizophrenia and Dental Health: A Systematic Review. The Journal of nervous and mental disease 2021; 209(9): 684-690 / doi:10.1097/NMD. 0000000000001371.
17. Gurbuz O, Alatas G, Kurt E, Dogan F, Issever H. Periodontal health and treatment needs among hospitalized chronic psychiatric patients in Istanbul, Turkey. Community dental health 2011; 28(1): 69-74.
18. Mörkl S, Wagner-Skacel J, Lahousen T, et al. The Role of Nutrition and the Gut-Brain Axis in Psychiatry: A Review of the Literature. Neuropsychobiology 2018; 1-9 / doi:10.1159/000492834.
19. Mobley CC. Nutrition and dental caries. Dental clinics of North America 2003; 47(2): 319-336 / doi: 10.1016/s0011-8532(02)00102-7.
20. Meyer JM, Stahl SM. The metabolic syndrome and schizophrenia. Acta psychiatrica Scandinavica 2009; 119(1): 4-14 / doi: 10.1111/j.1600-0447.2008.01317.x
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