Glossodynia

Glossodynia as an Expression of a Somatoform Disorder – a Hard-to-Grasp Psychodiagnostic Disease? With Presentation of a Single Case from a Psychodynamic Point of View

“…According to the ICD-10 classification, usually a K number is assigned to the GD patient (diseases of the oral cavity, salivary glands and jaw K 14.6), thus a primarily organic cause is suggested. As the initial diagnosis, F numbers (such as ICD-10 F 45.0, F 45.4, F 45.8, F 32.0, or F 54.4) are seldom assigned although many authors are of the opinion that a large proportion of GD cases are emotional in origin [11]. The group of patients with complaints in the mouth without organically demonstrable pathology is primarily classed under somatoform disorders and defined in the ICD-10 as follows: 'The characteristic is the recurrent presentation of physical symptoms in combination with stubborn demands for medical examinations, in spite of repeated negative results and assurance by the doctors that the symptoms have no physical basis.…”

“…Many authors attribute idiopathic GD to emotional causes [11]. Dermatologists consider emotional influence factors as important in the overwhelming majority [7].…”

“…He hypothesizes that GD symbolizes the fear of death (above all expressed as fear of cancer) localized in particular in the oral cavity that, being the site of food introduction, is directly connected with the preservation of life. Carcinophobia which is common in patients with GD is one of the hypochondriacal disorders [11]. From the psychodynamic point of view, the mouth and tongue region is of considerable significance from the earliest age onwards.…”

“…Psychotherapy (PT) alone is, in our experience, not sufficient, just as exclusively pharmacotherapy can often not succeed without supportive PT. Thus far, numerous articles have been published about the emotional causes of GD [11], but hardly any studies have been published in which longer terms of PT in GD patients are described. For this reason, the present single-case study describes the course of therapy with combined antidepressive drug therapy and psychodynamic 80-hour PT in a female patient with GD.…”

“…In addition to the term GD, there are several common terms, such as burning-mouth syndrome, burning tongue, glossalgia, glossopyrosis, oral dysestesia, 'oral galvanism', orodynia, orofacial pain syndrome, pain in the tongue, or stomatodynia. Even though GD may be elicited by a number of causes, (symptomatic GD), most cases must be classified as idiopathic (idiopathic GD) [11]. With pronounced complaints, which may involve the throat, the diagnosis of orofacial pain syndrome is made, in the sense of 'persistent somatoform pain disorder' (ICD-10, International Classification of Diseases 10: F 45.4) [36].…”