Malt U F, Nerdrum P, Oppedal B, Gundersen R, Holte M, Löne J
Department of Psychosomatic and Behavioural Medicine, National Hospital, Oslo, Norway.
Psychosom Med. 1997 Jan-Feb;59(1):32-41. doi: 10.1097/00006842-199701000-00005.
The physical and mental symptomatology of 99 self-referred patients complaining of multiple somatic and mental symptoms attributed to dental amalgam fillings were compared with patients with known chronic medical disorders seen in alternative (N = 93) and ordinary (N = 99) medical family practices and patients with dental amalgam fillings (N = 80) seen in an ordinary dental practice.
The assessments included written self-reports, a 131-item somatic symptom checklist; Eysenck Personality Questionnaire, the General Health Questionnaire, and Toronto Alexithymia Scale.
The dental amalgam sample reported significantly more physical symptoms from all body regions. Self-reports suggested that 62% suffered from a chronic anxiety disorder (generalized anxiety disorder or panic). Forty-seven percent suffered from a major depression compared with 14% in the two clinical-comparison samples and none in the dental control sample. Symptoms suggesting somatization disorder were found in 29% of the dental amalgam sample compared with only one subject in the 272 comparison subjects. One third of the dental amalgam patients reported symptoms of chronic fatigue syndrome compared with none in the dental control sample and only 2 and 6%, respectively, in the two clinical comparison samples. The dental amalgam group reported higher mean neuroticism and lower lie scores than the comparison groups.
Self-referred patients with health complaints attributed to dental amalgam are a heterogeneous group of patients who suffer multiple symptoms and frequently have mental disorders. There is a striking similarity with the multiple chemical sensitivity syndrome.
将99名自述因牙科汞合金填充物而出现多种躯体和精神症状的患者的身心症状,与在替代医疗家庭诊所(N = 93)和普通医疗家庭诊所(N = 99)就诊的已知慢性疾病患者以及在普通牙科诊所就诊的有牙科汞合金填充物的患者(N = 80)进行比较。
评估包括书面自我报告、一份131项的躯体症状清单;艾森克人格问卷、一般健康问卷和多伦多述情障碍量表。
牙科汞合金样本报告的来自身体所有部位的躯体症状明显更多。自我报告显示,62%的患者患有慢性焦虑症(广泛性焦虑症或惊恐障碍)。47%的患者患有重度抑郁症,而在两个临床对照样本中这一比例为14%,在牙科对照样本中则无人患病。在牙科汞合金样本中,29%的患者有提示躯体化障碍的症状,而在272名对照受试者中只有1人有此类症状。三分之一的牙科汞合金患者报告有慢性疲劳综合征的症状,而牙科对照样本中无人有此症状,在两个临床对照样本中这一比例分别仅为2%和6%。与对照组相比,牙科汞合金组报告的神经质得分更高,说谎得分更低。
自述因牙科汞合金而出现健康问题的患者是一组异质性患者,他们有多种症状,且经常患有精神障碍。这与多重化学敏感性综合征有显著相似之处。