BACKGROUND AND OBJECTIVE:The aim of this work was to investigate periodontal status, in relation to inflammatory markers and cortisol, in the gingival crevicular fluid and saliva of a homogenous group of women on long-term sick leave for job-stress related depression in comparison to nondepressed women.MATERIAL AND METHODS:The participants comprised 20 women with depression (DSM-IV) (mean age 48.5 +/- 6.9 years) and 29 healthy controls (mean age 54.5 +/- 2.9 years). Clinical examination was performed. Gingival crevicular fluid was collected by an intracrevicular washing technique. Interleukin-1 beta, interleukin-6, matrix metalloproteinase (MMP)-8 and MMP-9 were determined with enzyme-linked immunosorbent assay and cortisol was determined by using a radioimmunoassay. One-way analysis of covariance was used as the statistical method.RESULTS:The depressed patients had significantly higher gingival inflammation (p < 0.001), and deeper pockets (p < 0.003), than the healthy controls, after adjusting for age and smoking. The levels of interleukin-6 in the gingival crevicular fluid were significantly higher in the patients than in the controls: 3.84 +/- 1.58 pg per site and 0.79 +/- 1.83 pg per site, respectively, p < 0.003. There were no significant differences in the levels of interleukin-1 beta, MMP-8 and MMP-9. The patients had lower cortisol values in gingival crevicular fluid than the controls, whereas the levels of cortisol in saliva were similar in both groups.CONCLUSION:Women on long-term sick-leave for depression had more severe periodontitis and higher concentrations of interleukin-6 in gingival crevicular fluid than healthy controls. An alteration of the immune system in these patients might be interpreted as reflecting the consequences of long-term stress exposure and might contribute to worse periodontal conditions in these particular patients.

There is evidence, spanning many decades of research, that the subjective well-being (SWB) of workers, including life satisfaction, job satisfaction, and positive affect, positively correlates with the performance of workers and organizations. However, the size of the relationships is typically small to moderate. In this review we address the question of why the relationships are not stronger. We first review evidence of a relationship moving from well-being to performance through various pathways. Workers who are high in SWB are now understood to have: 1. better health, 2. lower absenteeism, 3. greater self-regulation, 4. stronger motivation, 5. enhanced creativity, 6. positive relationships, and 7. lower turnover. Each of these variables can predict individual and organizational performance. However, the sheer number of known and possible pathways means the relationships are bound to be complex, and there are mitigating conditions at every turn. Thus, second, we review the evidence of moderators of these mediators, hypothesizing when a happier workforce is a more productive one, and when not. Future research is needed to firmly establish the pathways from different types of SWB through the mediators to metrics of performance, to further establish the moderating conditions in which these relations are most likely to occur, and to evaluate how much SWB is needed to maximize effectiveness. We end by urging scholars to conduct this future research using the highest standards of scientific integrity.