Clinical psychiatric assessment of patients with burning mouth syndrome resisting oral treatment.
Of 100 consecutive patients referred for investigation of symptoms related to oral galvanism, 18 with persisting symptoms of burning mouth syndrome (BMS) remained after investigation and treatment (Hugoson 1986). In addition to the oral and medical treatment, 16 (14 women, 2 men) of these patients underwent psychiatric investigation. The results of this investigation are presented in this report. The psychiatric investigation was performed as a semistructured interview, elucidating current symptoms, the patient's opinion as to the onset and causes, previous illnesses and psycho-social conditions. Two hours were reserved for each patient interviewed with the aim of obtaining a holistic picture of each individual. The patients with refractory burning mouth syndrome did not differ from the others with respect to oral status, salivary secretion or calculated galvanic currents. No patient had burning mouth as the only symptom, all reporting many symptoms from different organs. Three patients had had symptoms for at least 20 years, 9 for 5-10 years and 4 patients for less than 4 years. Seven patients related the onset of symptoms to oral treatment. Thirteen of the patients reported one or more medical diagnoses and 10 patients were taking 1-3 medicines. Ten patients reported significant negative experiences in connection with previous contacts with the health services and several considered themselves wrongly diagnosed and treated. Most of the patients had experienced catastrophes in their lives in the form of stillborn children or children born with various handicaps, children injured in accidents or prolonged social problems. One patient was judged to have somatic causes of the symptoms, 8 patients somatic and psychological causes, 6 patients psychological causes and in 1 patient the cause was unknown. Three cases are presented in more detail.
Hammarén
M
M
Department of Psychiatry, Ryhov Central Hospital, Jönköping, Sweden.
Hugoson
A
A
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002054:Burning Mouth Syndrome / Q000503:physiopathology / Q000523:psychology*; D003778:Dentures; D004570:Electrogalvanism, Intraoral; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012463:Saliva / Q000502:physiology; D012649:Self Concept; D013997:Time Factors