抄録
The number of patients with oral psychosomatic disorders has increased in recent years. Our department established a psychosomatic disorder group for liaison with psychiatrists in the diagnosis and treatment of such patients in 1999. In this study, we report the clinical statistics for patients of this type who visited our department in 2004.
Most patients were female, and 79 percent of them were passing through menopause. This suggests that hormonal instability due to menopause may have been involved in their condition. About 30 percent complained of prolonged symptoms that had lasted for more than three years. A psychosomatic medical approach was clearly needed for them.
In terms of dental diagnosis, 50 percent had glossodynia. Psychiatric diagnosis based on the DSM-1V-TR diagnostic standard revealed that 77 percent of all patients had a somatoform disorder, and 41 percent a comorbidity psychiatric disorder. Twenty percent of all patients displayed concomitance with a major depressive disorder. More than 30 percent of patients complaining of sleep disturbance were diagnosed with a major depressive disorder, indicating a strong relationship between these two conditions.
It follows that dentists require a knowledge of such psychiatric disorders as depression in order to refer such patients to psychiatrists and obtain appropriate advice. Even though the symptoms are observed in the oral area, attention does have to be paid to mental aspects of the patients. Our group adopts a psychosomatic approach based on both dental and psychiatric aspects, recognizing the importance of consultative liaison in medicine.
Twenty-five percent of the patients were cured after 6 months by a combination of medication, dohsa-therapy, and laser therapy, on this basis of providing supportive mental therapy.
We emphasize the importance of establishing a system of referral between general dentists and hospitals for patients who need a psychosomatic approach.
