Symptom severity in burning mouth syndrome associates with psychological factors

Abstract

Burning mouth syndrome (BMS) patients are psychologically distressed, but whether this associates with symptom severity is unclear. The aim was to investigate the association of psychological factors with pain intensity and interference in BMS. Fifty‐two women (mean age 63.1, SD 10.9) with BMS participated. Pain intensity and interference data were collected using 2‐week pain diaries. Psychological factors were evaluated using Depression Scale (DEPS), Pain Anxiety Symptom Scale (PASS) and Pain Vigilance and Awareness Questionnaire (PVAQ). The local ethical committee approved the study. Patients were divided into groups based on pain severity distribution tertiles: low intensity (NRS ≤ 3.7) or interference (NRS ≤ 2.9) (tertiles 1‐2, n = 35) and moderate to intense intensity (NRS > 3.7) or interference (>2.9) (tertile 3, n = 17). T test, Wilcoxon's test and Pearson's correlation coefficient were used in the analyses. Patients in the highest intensity and interference tertiles reported more depression (P = .0247 and P = .0169) and pain anxiety symptoms (P = .0359 and P = .0293), and were more preoccupied with pain (P = .0004 and P = .0003) than patients in the low intensity and interference groups. The score of the pain vigilance questionnaire correlated significantly with pain intensity (r = .366, P = .009) and interference (r = .482, P = .009). Depression (r = .399, P = .003) and pain anxiety symptoms (r = .452, P = .001) correlated with pain interference. Symptom severity in BMS associates with symptoms of psychological distress emphasising the need to develop multidimensional diagnostics for the assessment of BMS pain.

Vortioxetine versus other antidepressants in the treatment of burning mouth syndrome: An open‐label randomized trial

“…Pain and psychological distress are strictly interconnected because patients suffering chronic pain are at risk of developing long‐lasting anxiety and depression, just as patients with mood disorders can report somatic pain (Blackburn‐Munro & Blackburn‐Munro, 2001; Chou, 2007). In previous studies, a high prevalence of anxiety, depression, and sleep disturbance (Adamo et al., 2018; Galli et al, 2017; Schiavone et al, 2012) in patients with BMS has been reported; similarly, Forssel et al have evidenced, in a recent article, that patients with a higher intensity of pain show an increased level of depression and anxiety symptoms (Forssel, Teerijoki‐Oksa, Puukka, & Estlander, 2020).…”

The association between burning mouth syndrome and urologic chronic pelvic pain syndrome: A case‐control study

“…The referred symptoms are multifarious including burning, xerostomia, sialorrhea, taste disturbances, itching, and coating tongue, and the most common affected sites are tongue, palate, gingivae, and lower lips 20 . While the association with sleep disturbances and psychological disorders is widely documented, 21 few data are presented on other somatic comorbidities. Moisset et al reported rare co‐occurrence of pain and BMS, often represented by headache, TMDs, atypical facial pain, trigeminal neuralgia, post‐herpetic facial pain, back pain, fibromyalgia, joint pain, abdominal pain, rectal pain, or vulvodynia 22 .…”

Catastrophising, pain self‐efficacy and acceptance in patients with Burning Mouth Syndrome

“…Partial correlations (parametric and non‐parametric) controlling for pain severity were subsequently administered for significant bivariate correlations. To control for possible type I errors due to multiple tests of associations, the false discovery rate approach was applied to the set of correlations with control set to 5% 21 . Associations between questionnaire scale scores and demographic and clinical characteristics measures were explored using Pearson correlation coefficients (and Spearman's rho ) and independent groups t tests.…”

“…It is surprising then that despite the long‐held and ongoing interest in the relationship between affective dysfunction and BMS, 8,9,18 few studies with BMS patients have examined beliefs about personal capacities to cope with or adapt to chronic pain and their association with patient mood and symptom management. A small number of studies have reported that pain‐specific psychological variables including catastrophising, pain anxiety and pain hypervigilance influence pain severity, pain interference and oral HRQoL in BMS, 4,19‐21 suggesting these are important components of patients’ pain experience. However, the association of catastrophising with BMS patient levels of anxiety or depressive symptoms is not clear, and as recently noted by Forssell and colleagues, 21 little is known about the resilience aspects of pain in BMS patients, which include pain self‐efficacy and chronic pain acceptance.…”

“…A small number of studies have reported that pain‐specific psychological variables including catastrophising, pain anxiety and pain hypervigilance influence pain severity, pain interference and oral HRQoL in BMS, 4,19‐21 suggesting these are important components of patients’ pain experience. However, the association of catastrophising with BMS patient levels of anxiety or depressive symptoms is not clear, and as recently noted by Forssell and colleagues, 21 little is known about the resilience aspects of pain in BMS patients, which include pain self‐efficacy and chronic pain acceptance. As such, the purpose of this study was to provide a comprehensive examination of beliefs about personal effectiveness in managing or adapting to pain in patients with BMS, and explore the relationships of catastrophising, chronic pain acceptance and pain self‐efficacy with affective (dys)function and oral and generic HRQoL.…”