Takao Chihiro, Watanabe Motoko, Nayanar Gayatri, Tu Trang, Umezaki Yojiro, Takenoshita Miho, Motomura Haruhiko, Nagamine Takahiko, Toyofuku Akira
Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN.
Department of Basic Dental Science, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM.
Cureus. 2023 Dec 26;15(12):e51139. doi: 10.7759/cureus.51139. eCollection 2023 Dec.
Introduction Burning mouth syndrome (BMS) is characterized as chronic burning pain or unpleasant discomfort in the oral region without any corresponding clinical abnormalities. The aim of this study is to investigate the difference in clinical features and the variations of pain expressions between BMS patients with and without psychiatric comorbidities. Methodology The patients with BMS who first visited between April 2016 and March 2020 were involved and the clinical data including the presence of psychiatric comorbidities and scores of self-rating depression scale (SDS), pain catastrophizing scale (PCS), and pain quality from short-form McGill pain questionnaire (SF-MPQ) were collected retrospectively. Results In 834 patients with BMS (700 females, 63.9 ± 13.1 years old), 371 patients (44.5%) had psychiatric comorbidities. There was no significant between-group difference in demographic data. However, significantly higher scores were observed in SDS (p < 0.001) and PCS (p < 0.001) in the patients with psychiatric comorbidities. Moreover, the patients with psychiatric comorbidities showed significantly stronger pain intensity (p < 0.001) besides higher scores of each descriptor in SF-MPQ. In addition, they had chosen more descriptors in SF-MPQ (p < 0.001); furthermore, the number of selected pain descriptors showed a stronger correlation with PCS than with SDS regardless of the presence of psychiatric comorbidities. Conclusion BMS patients may complain of various pain expressions regardless of the psychiatric comorbidities; however, more severe complaints relating to high pain catastrophizing are more likely in patients with psychiatric comorbidities. These results suggested that underlying anxiety exacerbated the variety of pain expressions in BMS patients with psychiatric comorbidities.
引言
灼口综合征（BMS）的特征是口腔区域出现慢性灼痛或不适，而无任何相应的临床异常。本研究的目的是调查伴有和不伴有精神疾病共病的BMS患者在临床特征和疼痛表现变化方面的差异。
方法
纳入2016年4月至2020年3月首次就诊的BMS患者，回顾性收集临床资料，包括精神疾病共病情况、自评抑郁量表（SDS）评分、疼痛灾难化量表（PCS）评分以及简短McGill疼痛问卷（SF-MPQ）的疼痛性质评分。
结果
在834例BMS患者（700例女性，年龄63.9±13.1岁）中，371例患者（44.5%）有精神疾病共病。两组在人口统计学数据上无显著差异。然而，伴有精神疾病共病的患者在SDS（p<0.001）和PCS（p<0.001）上的得分显著更高。此外，伴有精神疾病共病的患者除了SF-MPQ中每个描述词的得分更高外，疼痛强度也显著更强（p<0.001）。此外，他们在SF-MPQ中选择的描述词更多（p<0.001）；而且，无论是否存在精神疾病共病，所选疼痛描述词的数量与PCS的相关性都比与SDS的相关性更强。
结论
无论是否存在精神疾病共病，BMS患者都可能主诉各种疼痛表现；然而，伴有精神疾病共病的患者更有可能出现与高疼痛灾难化相关的更严重主诉。这些结果表明，潜在的焦虑加剧了伴有精神疾病共病的BMS患者疼痛表现的多样性。
