The onset and aggravation of symptoms in patients with oral lichen planus (OLP) are related to psychosomatic constitution and stress involvement. The aim of this study was to evaluate the influence of stressful life events and neuroticism as a personality trait in patients with OLP. A total of 32 patients with clinically and histopathological proven cases of OLP (16 with the nonerosive and 16 with erosive form), along with 31 healthy controls without oral lesions matched for age and sex were included in the study. Neurotic tendency and intensity of anxiety, depression, and negative affects and the number and type of stressful life events were investigated by the instruments Big Five Plus Two and Holmes and Rahe`s Social Readjustment Rating Scale, respectively. Data about life experience in war and its consequences were also collected. Univariate and multivariate analysis showed significantly greater anxiety, depression and negative affects tendency, as well as greater intensity and number of experienced stressful life events compared with controls (P<0.01). The distribution of subjects with at least one stressful event (P<0.01), family matters (P<0.01) and war experiences (P<0.05) was significant in the OLP group. The logistic regression results (OR=1.97) indicate that with each new stressful event a person is about two times more likely to get OLP. The degree, number, and type of stressful life changes and neuroticisms tendency independently play an important role in the onset or reactivation of OLP, depending on the individual's psychological constitution and the large differences in each person's ability to cope and their particular reactions to stress.
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