Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain

2011 ◽  
Vol 2 (4) ◽  
pp. 155-160 ◽  
Author(s):  
Tero Taiminen ◽  
Laura Kuusalo ◽  
Laura Lehtinen ◽  
Heli Forssell ◽  
Nora Hagelberg ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Orofacial Pain ◽  
Burning Mouth Syndrome ◽  
Atypical Facial Pain ◽  
Obsessive Compulsive ◽  
Axis I ◽  
Chronic Pain Conditions ◽  
Chronic Course

AbstractBackground and aimsBurning mouth syndrome (BMS) and atypical facial pain (AFP) are often persistent idiopathic pain conditions that mainly affect middle-aged and elderly women. They have both been associated with various psychiatric disorders. This study examined current and lifetime prevalence of psychiatric axis I (symptom-based) and II (personality) disorders in patients with chronic idiopathic orofacial pain, and investigated the temporal relationship of psychiatric disorders and the onset of orofacial pain.MethodForty patients with BMS and 23 patients with AFP were recruited from Turku university hospital clinics. Mean age of the patients was 62.3 years (range 35–84) and 90% were female. BMS and AFP diagnoses were based on thorough clinical evaluation, and all patients had undergone clinical neurophysiological investigations including blink reflex and thermal quantitative tests. Current and lifetime DSM-IV diagnoses of axis I and II disorders were made on clinical basis with the aid of SCID-I and II-interviews. The detected prevalence rates and their 95% confidence intervals based on binomial distribution were compared to three previous large population-based studies.ResultsOf the 63 patients, 26 (41.3%) had had an axis I disorder that preceded the onset of orofacial pain, and 33 (52.4%) had had a lifetime axis I disorder. Rate of current axis I disorders was 36.5%, indicating that only about 16% of lifetime disorders had remitted, and they tended to run chronic course. The most common lifetime axis I disorders were major depression (30.2%), social phobia (15.9%), specific phobia (11.1%), and panic disorder (7.9%). Twelve patients (19.0%) had at least one cluster C personality disorder already before the emergence of orofacial pain. Patients with cluster C personality disorders are characterized as fearful and neurotic. None of the patients had cluster A (characterized as odd and eccentric) or B (characterized as dramatic, emotional or erratic) personality disorders. The most common personality disorders were obsessive–compulsive personality (14.3%), dependent personality (4.8%), and avoidant personality (3.2%). The majority of the patients (54%) had also one or more chronic pain conditions other than orofacial pain. In almost all patients (94%) they were already present at the onset of orofacial pain.ConclusionsOur results suggest that major depression, persistent social phobia, and neurotic, fearful, and obsessive–compulsive personality characteristics are common in patients with chronic idiopathic orofacial pain. Most psychiatric disorders precede the onset of orofacial pain and they tend to run a chronic course.ImplicationsWe propose that the high psychiatric morbidity, and comorbidity to other chronic pain conditions, in chronic idiopathic orofacial pain can be best understood in terms of shared vulnerability to both chronic pain and specific psychiatric disorders, most likely mediated by dysfunctional brain dopamine activity.

Chronic Pain and Overview or Differential Diagnoses of Nonodontogenic Orofacial Pain

2018 ◽  
Vol 7 (4) ◽  
pp. 71-82
Author(s):  
Tara Renton
Keyword(s):  
Chronic Pain ◽  
Orofacial Pain ◽  
Correct Diagnosis ◽  
Temporomandibular Joint Disorders ◽  
Primary Headaches ◽  
Medical Treatments ◽  
Surgical Interventions ◽  
Idiopathic Pain ◽  
The Face ◽  
Chronic Pain Conditions

Orofacial pain is defined as pain arising from the regions of the face and mouth. Dental pain is the most common inflammatory pain presenting in this region; however, chronic pain conditions presenting frequently, including temporomandibular joint disorders (TMDs), primary headaches (neurovascular), neuropathic pain and idiopathic pain conditions, can often mimic toothache. Dentists are familiar with TMDs but have no training or experience in diagnosing or treating headaches that mainly present in the first trigeminal division. The anatomical complexity of the region and the potential possible diagnoses, mean that correct diagnosis is often delayed resulting in patients often undergoing inappropriate surgical and medical treatments that themselves may complicate the presentation of the pain by changing its phenotype and further complicating diagnosis and appropriate management. Due to the variable pain presentation of toothache, it can mimic many different chronic episodic orofacial pain conditions, resulting in many inappropriately prescribed courses of antibiotics and surgical interventions. Dentists are not the only profession to fall foul of the misdiagnosis but ear, nose and throat (ENT) and maxillofacial surgeons fall into the same trap.

scholarly journals Mental Disorders in Individuals With Exercise Addiction—A Cross-Sectional Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Maximilian Meyer ◽  
Isabel Sattler ◽  
Hanna Schilling ◽  
Undine E. Lang ◽  
André Schmidt ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Depressive Disorders ◽  
Clinical Diagnostics ◽  
Obsessive Compulsive ◽  
Cross Sectional ◽  
Addictive Disorders ◽  
Exercise Addiction ◽  
Dsm 5

Background and Aims: Exercise addiction has not yet been designated as an addictive disorder in the DSM-5 due to a lack of detailed research. In particular, associations with other psychiatric diagnoses have received little attention. In this study, individuals with a possible exercise addiction are clinically assessed, in order to establish a profile of co-occurring psychiatric disorders in individuals with exercise addiction.Methods: One hundred and fifty-six individuals who reported exercising more than 10 h a week, and continued to do so despite illness or injury, were recruited for the study. Those who met the cut-off of the Exercise Dependence Scale (n = 32) were invited to participate in a screening with the Structured Clinical Interview for DSM-5 (SCID-5-CV) and personality disorders (SCID-5-PD). Additionally, an interview based on the DSM-5 criteria of non-substance-related addictive disorders was conducted to explore the severity of exercise addiction symptoms.Results: 75% of participants fulfilled the criteria for at least one psychiatric disorder. Depressive disorders (56.3%), personality disorders (46.9%) and obsessive-compulsive disorders (31.3%) were the most common disorders. Moreover, there was a significant positive correlation between the number of psychiatric disorders and the severity of exercise addiction (r = 0.549, p = 0.002).Discussion: The results showed a variety of mental disorders in individuals with exercise addiction and a correlation between the co-occurrence of mental disorders and the severity of exercise addiction. Exercise addiction differs from other addictive und substance use disorders, as obsessive-compulsive (Cluster C), rather than impulsive (Cluster B) personality traits were most commonly identified.Conclusions: Our results underscore the importance of clinical diagnostics, and indicate that treatment options for individuals with exercise addiction are required. However, the natural history and specific challenges of exercise addiction must be studied in more detail.

Overlapping Pain and Psychiatric Syndromes

2020 ◽  
Keyword(s):  
Chronic Pain ◽  
Psychiatric Disorders ◽  
Comorbid Condition ◽  
Health Practitioner ◽  
Social Environments ◽  
Human Beings ◽  
Hospital Administrators ◽  
The Usa ◽  
Technological Developments ◽  
Chronic Pain Conditions

When a health practitioner is at the bedside of a patient suffering from chronic pain and a psychiatric comorbid condition, he is facing a true clinical conundrum. The comorbidity is frequent yet poorly understood, the diagnosis is difficult and the treatment that follows is less than appropriate. Pain conditions and psychiatric disorders have customarily been understood and treated as different and separate clinical entities, to the detriment of patients’ wellbeing. Fathoming the overlapping pain and psychiatric disorders is in the interest of everyone involved in healthcare, including doctors, nurses, pain specialists, psychiatrists, social workers, psychologists, hospital administrators, and health policymakers. There is a wide overlap of chronic pain conditions and psychiatric disorders. Pain and psychiatric comorbidity is frequent in the population, yet it is poorly understood. The societal burden of mental illness and pain is enormous; it could approach one trillion dollars annually in the USA. Compounding to the economic burden, are the liability related to stigma, shame, bias, discrimination, health disparities, inequities in care, and health injustice. Recent scientific and technological developments in digital medicine, artificial intelligence, pharmacogenetics, genetics, epigenetics, and neuroscience promise beneficial quality changes to medical care and education. The pain medicine and psychiatry of the future will consider patients as human beings embedded in their physical and social environments. This book provides a glimpse in that direction.

Mechanical Chronic Jaw Pain

2018 ◽  
Author(s):  
Radhika P. Grandhe ◽  
Matthew Valeriano ◽  
Dmitri Souza
Keyword(s):  
Chronic Pain ◽  
Orofacial Pain ◽  
Multidisciplinary Treatment ◽  
Clinical History ◽  
High Prevalence ◽  
Common Causes ◽  
Tmj Pain ◽  
Chronic Pain Conditions ◽  
Muscles Of Mastication ◽  
Secondary Causes

Mechanical jaw pain and temporomandibular joint (TMJ) disorders are the most common causes of nondental orofacial pain. The pain can originate from the joint structures or from the muscles of mastication. Diagnosis is based predominantly on the clinical history and exam findings, but imaging is indicated in certain circumstances. Secondary causes of chronic jaw pain must be sought out and meticulously ruled out. Patients presenting with TMJ pain have a high prevalence of fibromyalgia and other chronic pain conditions. Multidisciplinary treatment involving medications, minimizing parafunctional habits, oral splints, physical therapy, psychotherapy, and injections forms the cornerstone of management of this complex condition. Surgery is indicated in select conditions, such as ankylosis of the joint or tumors.

The Need to Fathom Overlapping Pain and Psychiatric Syndromes

2020 ◽  
pp. 3-15
Author(s):  
Mario Incayawar
Keyword(s):  
Chronic Pain ◽  
Psychiatric Disorders ◽  
Well Being ◽  
The United States ◽  
Social Environments ◽  
Human Beings ◽  
Digital Medicine ◽  
Centered Care ◽  
Technological Developments ◽  
Chronic Pain Conditions

There is a wide overlap of chronic pain conditions and psychiatric disorders. Pain and psychiatric comorbidity is frequent in the population, yet it is poorly understood, research is scarce, the diagnosis is challenging, and the treatment that follows is often less than appropriate. Pain conditions and psychiatric disorders have customarily been understood and treated as different and separate clinical entities, to the detriment of patients’ well-being. The societal burden of mental illness and pain is enormous; it could approach $1 trillion annually in the United States. There are very limited data on the epidemiology and scope of the overlap between mental disorders and chronic pain. Compounding to the economic burden are the liability related to stigma, shame, bias, discrimination, health disparities, inequities in care, and health injustice. Recent scientific and technological developments in digital medicine, artificial intelligence, pharmacogenetics, genetics, epigenetics, and neuroscience promise beneficial quality changes to medical care and education. The pain medicine and psychiatry of the future will consider patients as human beings embedded in their physical and social environments. Health professionals are headed toward person-centered care and biologically individualized/personalized therapy or precision medicine.

Gender-related clinical differences in obsessive-compulsive disorder

1999 ◽  
Vol 14 (8) ◽  
pp. 434-441 ◽  
Author(s):  
F. Bogetto ◽  
S. Venturello ◽  
U. Albert ◽  
G. Maina ◽  
L. Ravizza
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Clinical Features ◽  
Age At Onset ◽  
Obsessive Compulsive ◽  
Course Of Illness ◽  
Compulsive Disorder ◽  
History Of ◽  
Axis I ◽  
Dsm Iv ◽  
Chronic Course

SummaryThe purpose of the present study was to investigate the gender-related differences of clinical features in a sample of obsessive-compulsive (OCD) patients. One hundred and sixty outpatients with a principal diagnosis of obsessive-compulsive disorder (DSM-IV, Y-BOCS = 16) were admitted. Patients were evaluated with a semi-structured interview covering the following areas: socio-demographic data, Axis I diagnoses (DSM-IV), OCD clinical features (age at onset of OC symptoms and disorder, type of onset, life events and type of course). For statistical analysis the sample was subdivided in two groups according to gender. We found an earlier age at onset of OC symptoms and disorder in males; an insidious onset and a chronic course of illness were also observed in that group of patients. Females more frequently showed an acute onset of OCD and an episodic course of illness; they also reported more frequently a stressful event in the year preceding OCD onset. A history of anxiety disorders with onset preceding OCD and hypomanic episodes occurring after OCD onset was significantly more common among males, while females showed more frequently a history of eating disorders. We found three gender-related features of OCD: males show an earlier age at onset with a lower impact of precipitant events in triggering the disorder; OCD seems to occur in a relative high proportion of males who already have phobias and/or tic disorders; and a surfeit of chronic course of the illness in males in comparison with females.

scholarly journals PARANOID SCHIZOPHRENIA -BETWEEN HYPERSEXUALITY AND SADOMASOCHISM

2021 ◽  
Vol 9 (3) ◽  
pp. 195-203
Author(s):  
Simona Trifu ◽  
Beligeanu Mihaela ◽  
Iacob Beatrice Ștefana ◽  
Larimian Ștefania Parisa
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Defense Mechanisms ◽  
Paranoid Schizophrenia ◽  
Point Of View ◽  
Obsessive Compulsive ◽  
Schizotypal Personality ◽  
Paternal Line ◽  
Axis I ◽  
Obsessive Compulsive Personality Disorder

Motivation/Background: In this paper we aimed at clinically analyzing a patient diagnosed with paranoid schizophrenia, who also displays features specific to multiple personality disorders, in the context of a presentation whose key topic is sexuality. Given the global prevalence and the severity of schizophrenia, it is increasingly important to appropriately adapt and identify the patients' clinical and non-clinical personality profile. This paper also aims at making the profile of a patient diagnosed with axis I disorder ever since the age of 19, who also has got traits specific to certain personality disorders. At the same time, the work provides an interpretation of the behaviour from the psycho-dynamic point of view. Method: The following instruments were used for performing the analysis: a clinical interview, heteroanamnesis, psychological tests, clinical course monitoring, psychodynamic interpretations, defence mechanisms identification, psychiatric observation and treatment. Results: Based on the materials aforementioned, it has been established a possible diagnosis which includes multiple disorders: Antisocial Personality Disorder, Histrionic Personality Disorder, Schizotypal Personality Disorder, Obsessive Compulsive Personality Disorder, Cotard Syndrome, Kandinsky-Clérambault Syndrome. and there were identified defense mechanisms and coping strategies, under the influence of sexuality and sadomasochistic impulses. Conclusions: It is highlighted the clinical picture of a patient with paranoid schizophrenia, who presents symptoms for differential diagnoses, with disorganized discourse focused on sexuality, with delusional ideation, psychotic manifestation, but also with high suggestibility, especially on the paternal line

scholarly journals The prevalence, age distribution and comorbidity of personality disorders in Australian women

2016 ◽  
Vol 51 (2) ◽  
pp. 141-150 ◽  
Author(s):  
Shae E Quirk ◽  
Michael Berk ◽  
Julie A Pasco ◽  
Sharon L Brennan-Olsen ◽  
Andrew M Chanen ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Psychiatric Disorders ◽  
Odds Ratio ◽  
Substance Misuse ◽  
Age Distribution ◽  
Clinical Interview ◽  
Obsessive Compulsive ◽  
Individual Personality ◽  
Dsm Iv

Objective: We aimed to describe the prevalence and age distribution of personality disorders and their comorbidity with other psychiatric disorders in an age-stratified sample of Australian women aged ⩾25 years. Methods: Individual personality disorders (paranoid, schizoid, schizotypal, histrionic, narcissistic, borderline, antisocial, avoidant, dependent, obsessive-compulsive), lifetime mood, anxiety, eating and substance misuse disorders were diagnosed utilising validated semi-structured clinical interviews (Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition and Structured Clinical Interview for DSM-IV Axis II Personality Disorders). The prevalence of personality disorders and Clusters were determined from the study population ( n = 768), and standardised to the Australian population using the 2011 Australian Bureau of Statistics census data. Prevalence by age and the association with mood, anxiety, eating and substance misuse disorders was also examined. Results: The overall prevalence of personality disorders in women was 21.8% (95% confidence interval [CI]: 18.7, 24.9). Cluster C personality disorders (17.5%, 95% CI: 16.0, 18.9) were more common than Cluster A (5.3%, 95% CI: 3.5, 7.0) and Cluster B personality disorders (3.2%, 95% CI: 1.8, 4.6). Of the individual personality disorders, obsessive-compulsive (10.3%, 95% CI: 8.0, 12.6), avoidant (9.3%, 95% CI: 7.1, 11.5), paranoid (3.9%, 95% CI: 3.1, 4.7) and borderline (2.7%, 95% CI: 1.4, 4.0) were among the most prevalent. The prevalence of other personality disorders was low (⩽1.7%). Being younger (25–34 years) was predictive of having any personality disorder (odds ratio: 2.36, 95% CI: 1.18, 4.74), as was being middle-aged (odds ratio: 2.41, 95% CI: 1.23, 4.72). Among the strongest predictors of having any personality disorder was having a lifetime history of psychiatric disorders (odds ratio: 4.29, 95% CI: 2.90, 6.33). Mood and anxiety disorders were the most common comorbid lifetime psychiatric disorders. Conclusions: Approximately one in five women was identified with a personality disorder, emphasising that personality disorders are relatively common in the population. A more thorough understanding of the distribution of personality disorders and psychiatric comorbidity in the general population is crucial to assist allocation of health care resources to individuals living with these disorders.

Incidence of axis I and axis II dual diagnosis in hospitalised patients with somatization disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1575-1575
Author(s):  
D. Vasile ◽  
O. Vasiliu ◽  
G. Grigorescu ◽  
A.G. Mangalagiu ◽  
D.G. Ojog ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Personality Disorders ◽  
Dual Diagnosis ◽  
Somatization Disorder ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Axis Ii ◽  
Associated Conditions ◽  
Axis I ◽  
Substance Related Disorders

IntroductionSomatization disorder is frequently associated in epidemiologic trials with depressive, anxiety, other somatoform or substance related disorders, as well as with personality disorders. An examination of psychiatric comorbidity in patients diagnosed with somatization disorder is strongly advised due to the impact of these associated conditions over the prognosis and treatment.ObjectiveTo establish the incidence of psychiatric dual diagnosis in hospitalized patients with somatization disorder.MethodsA group of 37 patients, 22 female and 15 male, mean age 45.9, were evaluated using Structured Clinical Interview for DSM Axis I (SCID-I) and Axis II (SCID-II) disorders at the admission in our department for a diagnosis of somatization disorder. All patients included in this trial were known with somatization disorder for at least one year prior to this admission.ResultsPatients diagnosed with somatization disorder presented mostly depressive disorders (46%, n = 17), anxiety disorders (37.8%, n = 14), substance related disorders (16.2%, n = 6) and personality disorders (67.5%, n = 25). A more detailed analysis on axis I established major depressive disorder as the most frequent diagnosis (37.8%, n = 14), followed by panic disorder (27%, n = 10) and alcohol dependence (13.5%, n = 5), while on axis II the histrionic (21.6%, n = 8) and obsessive-compulsive (19%, n = 7) personality disorders were the most frequently associated conditions. A number of 21 patients presented at least three axis I and/or II simultaneous diagnosis (64.8%).ConclusionThe most frequently comorbidities in somatization disorder are major depressive disorder and panic disorder on axis I, as well as histrionic and obsessive-compulsive personality disorder on axis II.

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