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Peculiar alexithymic traits in burning mouth syndrome: case–control study

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Abstract

Objectives

The present case–control study aims to assess the occurrence of alexithymic traits in burning mouth syndrome (BMS) subjects and to correlate alexithymic traits to anxious and depressive traits in BMS subjects.

Materials and methods

Prospectively enrolled BMS and control subjects were administered the 20-item Toronto Alexithymia Scale (TAS-20). Anxiety and depressive traits were assessed using the Hamilton Anxiety Rating Scale and the Montgomery and Asberg Depression Rating Scale. Occurrence of alexithymic traits was compared between BMS and control subjects. Correlation tests were used to measure the importance of alexithymic traits related to demographic characteristics, pain intensity (VAS score), and to the other psychometric scores.

Results

Fifty-eight BMS subjects (46 females and 12 males) had a mean TAS-20 score significantly higher when compared to controls (p < 0.001; r = 0.72), corresponding to an occurrence rate of alexithymic traits of 79.3 versus 6.9 %. Alexithymic traits in BMS subjects were just related to depressive traits (p = 0.02; ρ = 0.31).

Conclusions

The high occurrence of alexithymia in BMS is an adjunctive issue in favor of its multifactorial pathogenesis, with a not negligible role for somatization.

Clinical relevance

Clinicians should be aware of the high occurrence of alexithymic traits among BMS subjects as such traits may affect the doctor–patient relationship.

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References

  1. Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino MA (2003) Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med 14:275–291

    Article  PubMed  Google Scholar 

  2. Headache Classification Committee of the International Headache S (2013) The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia :Int J Headache 33:629–808. doi:10.1177/0333102413485658

    Article  Google Scholar 

  3. Mendak-Ziolko M, Konopka T, Bogucki ZA (2012) Evaluation of select neurophysiological, clinical and psychological tests for burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol 114:325–332. doi:10.1016/j.oooo.2012.04.004

    Article  PubMed  Google Scholar 

  4. Lauria G, Majorana A, Borgna M, Lombardi R, Penza P, Padovani A, Sapelli P (2005) Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome. Pain 115:332–337

    Article  PubMed  Google Scholar 

  5. Bogetto F, Maina G, Ferro G, Carbone M, Gandolfo S (1998) Psychiatric comorbidity in patients with burning mouth syndrome. Psychosom Med 60:378–385

    Article  PubMed  Google Scholar 

  6. Maina G, Albert U, Gandolfo S, Vitalucci A, Bogetto F (2005) Personality disorders in patients with burning mouth syndrome. J Personal Disord 19:84–93

    Article  Google Scholar 

  7. Abetz LM, Savage NW (2009) Burning mouth syndrome and psychological disorders. Aust Dental J 54:84–93. doi:10.1111/j.1834-7819.2009.01099.x, quiz 173

    Article  Google Scholar 

  8. Ducasse D, Courtet P, Olie E (2013) Burning mouth syndrome: current clinical, physiopathologic, and therapeutic data. Reg Anesth Pain Med 38:380–390. doi:10.1097/AAP.0b013e3182a1f0db

    Article  PubMed  Google Scholar 

  9. Tolmunen T, Heliste M, Lehto SM, Hintikka J, Honkalampi K, Kauhanen J (2011) Stability of alexithymia in the general population: an 11-year follow-up. Compr Psychiatry 52:536–541. doi:10.1016/j.comppsych.2010.09.007

    Article  PubMed  Google Scholar 

  10. Lane RD, Sechrest L, Riedel R (1998) Sociodemographic correlates of alexithymia. Compr Psychiatry 39:377–385

    Article  PubMed  Google Scholar 

  11. Salminen JK, Saarijarvi S, Aarela E (1995) Two decades of alexithymia. J Psychosom Res 39:803–807

    Article  PubMed  Google Scholar 

  12. Duddu V, Isaac MK, Chaturvedi SK (2006) Somatization, somatosensory amplification, attribution styles and illness behaviour: a review. Int Rev Psychiatry 18:25–33. doi:10.1080/09540260500466790

    Article  PubMed  Google Scholar 

  13. Schiavone V, Adamo D, Ventrella G, Morlino M, De Notaris EB, Ravel MG, Kusmann F, Piantadosi M, Pollio A, Fortuna G, Mignogna MD (2012) Anxiety, depression, and pain in burning mouth syndrome: first chicken or egg? Headache 52:1019–1025. doi:10.1111/j.1526-4610.2012.02171.x

    Article  PubMed  Google Scholar 

  14. McCracken LM, Zayfert C, Gross RT (1992) The Pain Anxiety Symptoms Scale: development and validation of a scale to measure fear of pain. Pain 50:67–73

    Article  PubMed  Google Scholar 

  15. Jones MP, Schettler A, Olden K, Crowell MD (2004) Alexithymia and somatosensory amplification in functional dyspepsia. Psychosomatics 45:508–516. doi:10.1176/appi.psy.45.6.508

    Article  PubMed  Google Scholar 

  16. Millard RW, Kinsler BL (1992) Evaluation of constricted affect in chronic pain: an attempt using the Toronto Alexythymia Scale. Pain 50:287–292

    Article  PubMed  Google Scholar 

  17. Jerlang BB (1997) Burning mouth syndrome (BMS) and the concept of alexithymia—a preliminary study. J Oral Pathol Med 26:249–253

    Article  PubMed  Google Scholar 

  18. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370:1453–1457. doi:10.1016/s0140-6736(07)61602-x

    Article  Google Scholar 

  19. Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M, for the SI (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS medicine 4:e297. doi:10.1371/journal.pmed.0040297

    Article  PubMed Central  PubMed  Google Scholar 

  20. Carbone M, Pentenero M, Carrozzo M, Ippolito A, Gandolfo S (2009) Lack of efficacy of alpha-lipoic acid in burning mouth syndrome: a double-blind, randomized, placebo-controlled study. Eur J Pain 13:492–496. doi:10.1016/j.ejpain.2008.06.004

    Article  PubMed  Google Scholar 

  21. Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE, Fox PC, Fox RI, Kassan SS, Pillemer SR, Talal N, Weisman MH, and European Study Group on Classification Criteria for Sjogren's S (2002) Classification criteria for Sjogren's syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheumatic Dis 61:554–558

    Article  Google Scholar 

  22. Bagby RM, Parker JD, Taylor GJ (1994) The twenty-item Toronto Alexithymia Scale–I. Item selection and cross-validation of the factor structure. J Psychosom Res 38:23–32

    Article  PubMed  Google Scholar 

  23. Bagby RM, Taylor GJ, Parker JD (1994) The Twenty-item Toronto Alexithymia Scale–II. Convergent, discriminant, and concurrent validity. J Psychosom Res 38:33–40

    Article  PubMed  Google Scholar 

  24. Taylor G, Bagby RM, Parker JDA (1997) Disorder of affect regulation: alexithymia in medical and psychiatric illness. Cambridge University Press, Cambridge

    Book  Google Scholar 

  25. Mattila AK, Salminen JK, Nummi T, Joukamaa M (2006) Age is strongly associated with alexithymia in the general population. J Psychosomatic Res 61:629–635. doi:10.1016/j.jpsychores.2006.04.013

    Article  Google Scholar 

  26. Silvestre FJ, Silvestre-Rangil J, Tamarit-Santafe C, Bautista D (2012) Application of a capsaicin rinse in the treatment of burning mouth syndrome. Med Oral Patol Oral Cir Bucal 17:e1–e4

    Article  PubMed Central  PubMed  Google Scholar 

  27. Lopez-Jornet P, Camacho-Alonso F, Andujar-Mateos P (2011) A prospective, randomized study on the efficacy of tongue protector in patients with burning mouth syndrome. Oral Dis 17:277–282. doi:10.1111/j.1601-0825.2010.01737.x

    Article  PubMed  Google Scholar 

  28. Sardella A, Lodi G, Demarosi F, Tarozzi M, Canegallo L, Carrassi A (2008) Hypericum perforatum extract in burning mouth syndrome: a randomized placebo-controlled study. J Oral Pathol Med 37:395–401. doi:10.1111/j.1600-0714.2008.00663.x

    Article  PubMed  Google Scholar 

  29. Minguez-Sanz MP, Salort-Llorca C, Silvestre-Donat FJ (2011) Etiology of burning mouth syndrome: a review and update. Med Oral Patol Oral Cir Bucal 16:e144–e148

    Article  PubMed  Google Scholar 

  30. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.

  31. Sifneos PE (1973) The prevalence of 'alexithymic' characteristics in psychosomatic patients. Psychother Psychosom 22:255–262

    Article  PubMed  Google Scholar 

  32. De Gucht V (2003) Stability of neuroticism and alexithymia in somatization. Compr Psychiatry 44:466–471. doi:10.1016/s0010-440x(03)00143-3

    Article  PubMed  Google Scholar 

  33. Mattila AK, Kronholm E, Jula A, Salminen JK, Koivisto AM, Mielonen RL, Joukamaa M (2008) Alexithymia and somatization in general population. Psychosomatic Med 70:716–722. doi:10.1097/PSY.0b013e31816ffc39

    Article  Google Scholar 

  34. De Gucht V, Heiser W (2003) Alexithymia and somatisation—a quantitative review of the literature. J Psychosom Res 54:425–434. doi:10.1016/S0022-3999(02)00467-1

    Article  PubMed  Google Scholar 

  35. Bach M, Bach D (1995) Predictive value of alexithymia: a prospective study in somatizing patients. Psychother Psychosom 64:43–48

    Article  PubMed  Google Scholar 

  36. Zakrzewska JM, Forssell H and Glenny AM (2005) Interventions for the treatment of burning mouth syndrome. Cochrane Database Syst Rev:CD002779

  37. Leweke F, Leichsenring F, Kruse J, Hermes S (2012) Is alexithymia associated with specific mental disorders? Psychopathology 45:22–28. doi:10.1159/000325170

    Article  PubMed  Google Scholar 

  38. Son SH, Jo H, Rim HD, Kim JH, Kim HW, Bae GY, Lee SJ (2012) A comparative study on alexithymia in depressive, somatoform, anxiety, and psychotic disorders among Koreans. Psychiatry Investig 9:325–331. doi:10.4306/pi.2012.9.4.325

    Article  PubMed Central  PubMed  Google Scholar 

  39. Celikel FC, Kose S, Erkorkmaz U, Sayar K, Cumurcu BE, Cloninger CR (2010) Alexithymia and temperament and character model of personality in patients with major depressive disorder. Compr Psychiatry 51:64–70. doi:10.1016/j.comppsych.2009.02.004

    Article  PubMed  Google Scholar 

  40. Honkalampi K, Hintikka J, Tanskanen A, Lehtonen J, Viinamaki H (2000) Depression is strongly associated with alexithymia in the general population. J Psychosom Res 48:99–104. doi:10.1016/s0022-3999(99)00083-5

    Article  PubMed  Google Scholar 

  41. Vadacca M, Bruni R, Terminio N, Sambataro G, Margiotta D, Serino FM, Afeltra A (2014) Alexithymia, mood states and pain experience in systemic lupus erythematosus and rheumatoid arthritis. Clin Rheumatol 33:1443–1450. doi:10.1007/s10067-014-2593-3

    Article  PubMed  Google Scholar 

  42. Kojima M, Kojima T, Suzuki S, Takahashi N, Funahashi K, Kato D, Hanabayashi M, Hirabara S, Asai S, Ishiguro N (2014) Alexithymia, depression, inflammation, and pain in patients with rheumatoid arthritis. Arthritis Care Res 66:679–686. doi:10.1002/acr.22203

    Article  Google Scholar 

  43. Celikel FC, Saatcioglu O (2006) Alexithymia and anxiety in female chronic pain patients. Ann Gen Psychiatry 5:13. doi:10.1186/1744-859x-5-13

    Article  PubMed Central  PubMed  Google Scholar 

  44. Graugaard PK, Holgersen K, Finset A (2004) Communicating with alexithymic and non-alexithymic patients: an experimental study of the effect of psychosocial communication and empathy on patient satisfaction. Psychother Psychosom 73:92–100. doi:10.1159/000075540

    Article  PubMed  Google Scholar 

  45. Taylor GJ (1984) Alexithymia: concept, measurement, and implications for treatment. Am J Psychiatry 141:725–732

    Article  PubMed  Google Scholar 

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Funding

The present study did not have any funding source.

Conflict of interest

The authors have no conflict of interest to declare (current and over the past 5 years).

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Authors and Affiliations

  1. Unit of Oral Medicine and Oral Oncology, Department of Oncology, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy

    Roberto Marino, Sergio Gandolfo & Monica Pentenero

  2. Department of Clinical and Biological Sciences, Mental Health Department, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy

    Rocco Luigi Picci, Giovanni Ferro & Claudio Carezana

Authors
  1. Roberto Marino
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  2. Rocco Luigi Picci
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  3. Giovanni Ferro
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  5. Sergio Gandolfo
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  6. Monica Pentenero
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Correspondence to Sergio Gandolfo.

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Marino, R., Picci, R.L., Ferro, G. et al. Peculiar alexithymic traits in burning mouth syndrome: case–control study. Clin Oral Invest 19, 1799–1805 (2015). https://doi.org/10.1007/s00784-015-1416-5

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  • DOI: https://doi.org/10.1007/s00784-015-1416-5

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