title: Psychiatric comorbidities and psychopharmacological outcomes of phantom bite syndrome.
abstract: OBJECTIVE
  Phantom bite syndrome (PBS) is characterized by a persistent uncomfortable sensation of occlusion without an evident occlusal discrepancy. The aims of this retrospective cross-sectional study were to assess psychiatric comorbidities and evaluate psychopharmacological outcomes of PBS.
  
  
  METHODS
  The database of the Psychosomatic Dentistry Clinic of Tokyo Medical and Dental University Dental Hospital was reviewed for cases of PBS diagnosed between April 2009 and March 2012. Clinical Global Impression indices were used to assess psychopharmacological outcomes.
  
  
  RESULTS
  The review revealed 130 patients (107 women, 23 men) with a mean age of 53.0 ±13.1 years. They previously visited 4.4 ±3.4 dental clinicsand had a mean symptom duration of 5.3 ±5.4 years. Only 24 (18.5%) of 63 (48.5%) patients with psychiatric comorbidities had schizophrenia, major depressive disorder, or bipolar disorder. The frequency of psychiatric comorbidities was significantly lower in PBS with a dental trigger than that without a specific trigger. Moreover, patients without a psychiatric comorbidity showed significantly better outcomes than those with a psychiatric comorbidity. Forty patients (30.8%) showed remarkable clinical improvement after receiving amitriptyline, mirtazapine, or aripiprazole.
  
  
  CONCLUSIONS
  PBS is generally not associated with severe psychiatric disorders. Absence of a dental trigger predicts a psychiatric comorbidity, which affects the psychopharmacological outcome. Antidepressant or antipsychotic therapy may be effective for symptom management in PBS.
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: totoompm@tmd.ac.jp.
authors.forename: Motoko
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Umezaki
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Spica
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Anna
authors.initials: A
authors.lastname: Miura
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Shinohara
authors.affiliation: Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, Tokyo, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, Tokyo, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Sakuma
authors.affiliation: Psychosomatic Dentistry Clinic, Tokyo Medical and Dental University Dental Hospital, Tokyo, Japan.
authors.forename: Chisa
authors.initials: C
authors.lastname: Shitano
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Katagiri
authors.affiliation: Department of Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Takenoshita
authors.affiliation: Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Toyofuku
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003702:Delusions / Q000188:drug therapy* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents
keywords: Antidepressants; Dental treatment; Phantom bite syndrome; Psychiatric disorder; Psychopharmacology; Trigger