title: Oral Dysesthesia Rating Scale: a tool for assessing psychosomatic symptoms in oral regions.
abstract: BACKGROUND
  The concept of cenesthopathy was first introduced by Dupré and Camus in 1907 to describe clinically unexplainable bodily sensations mainly attributed to psychiatric pathology. If it occurs in oral regions, it is termed oral cenesthopathy and it has been of special interest to psychiatrists and dentists. While there is no independently defined criteria for this condition, which is classified as either a delusional or a somatoform disorder, clinical practice and research require a standard scale to measure and rate its symptoms. In this study, we included any types of psychosomatic symptoms in oral regions as oral dysesthesia, and developed an Oral Dysesthesia Rating Scale (Oral DRS) and evaluated its validity and reliability as an assessment tool.
  
  
  METHODS
  The scale was developed based on literature review and extensive clinical experience. Twelve reviewers assessed relevancy of each item to oral dysesthesia symptoms by 1-4 scoring scale and item content validity index was computed. To evaluate the inter-rater reliability of Oral DRS, pairs of raters administered the scale to 40 randomly selected patients with complaints of oral dysesthesia symptoms and Cohen's weighted kappa coefficient was determined for each item.
  
  
  RESULTS
  The scale assesses the severity of feelings of foreign body [A1], exudation [A2], squeezing-pulling [A3], movement [A4], misalignment [A5], pain [A6], and spontaneous thermal sensation or tastes [A7], and the degree of impairment in eating [B1], articulation [B2], work [B3], and social activities [B4] on a scale of 0-5. Items A1, A2, A3, A4, B3, and B4 demonstrated acceptable content validity. Inter-rater reliabilities were good or excellent for all items evaluated.
  
  
  CONCLUSIONS
  The Oral DRS can help define the nosography of clinically unexplainable oral dysesthesia through further case evaluation and clinical research and facilitate devising of treatment modalities.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. uezapsyc@tmd.ac.jp.|Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, 1713 6th Avenue South, Birmingham, AL, 35294, USA. uezapsyc@tmd.ac.jp.
authors.forename: Akihito
authors.initials: A
authors.lastname: Uezato
authors.affiliation: Section of Psychosomatic Dentistry, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. ompm.ompm@tmd.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Toyofuku
authors.affiliation: Section of Psychosomatic Dentistry, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. umezaki.vikings@hotmail.co.jp.|Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA. umezaki.vikings@hotmail.co.jp.
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Umezaki
authors.affiliation: Section of Psychosomatic Dentistry, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. totoompm@tmd.ac.jp.
authors.forename: Motoko
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Diagnostic Radiology and Oncology, Tokyo Dental and Medical University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. trihmrad@tmd.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Toriihara
authors.affiliation: Clinical Research Center, Tokyo Medical and Dental University Hospital Faculty of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. tomita.crc@tmd.ac.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Tomita
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. n_yamamoto.psyc@tmd.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. 0724.psyc@tmd.ac.jp.
authors.forename: Akeo
authors.initials: A
authors.lastname: Kurumaji
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. tnis.psyc@tmd.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Nishikawa
mesh_terms: D000368:Aged; D003702:Delusions / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009059:Mouth Diseases / Q000175:diagnosis*; D015588:Observer Variation; D010292:Paresthesia / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis*; D063189:Symptom Assessment / Q000379:methods