Sensibility threshold in depressive and nondepressive patients with chronic orofacial pain.

Sensibility threshold was measured in patients with depressive and nondepressive psychiatric disorders, where both groups were suffering from chronic orofacial pain. The control patients had no pain and no signs of mental disturbance. Patients with major depressive disorders had a significantly lower sensibility threshold than patients with milder depressive disorders, while patients with milder depressive disorders had a significantly lower sensibility threshold than patients with nondepressive mental disorders. The controls had the highest sensibility threshold. Plasma, beta-endorphin, cortisol and prolactin levels were also measured. The depressed patients were found to have a lower serum beta-endorphin level than the nondepressive patients and the controls, although the difference was not statistically significant.

Psychiatric disorders in orofacial dysaesthesia.

70 patients with orofacial dysaesthesia were clinically examined at the Department of Oral and Maxillofacial Surgery of the University of Helsinki. All the patients were referred for a psychiatric consultation. Later 16 refused to attend. 12 of the 54 patients (22.2%) who took part in the psychiatric interview were psychotic, 27 patients (50.0%) had a moderate mental disorder and 11 patients (20.4%) a mild psychiatric disorder. 4 of the patients had no psychic diagnosis (psychically healthy). The control group, which comprised 44 patients referred to the Department for surgical extraction of an impacted tooth, filled in the Cornell Medical Index questionnaire. 3 of the controls (6.8%) had a severe mental disturbance, 5 (11.4%) a moderate psychic disorder and 4 (9.1%) a mild psychiatric disorder, whereas 32 patients (72.7%) were mentally healthy. The results show that there is a psychic background in most patients with chronic orofacial pain who have no clinical findings corresponding to the sensation of somatic pain.

Psychiatric disturbance in patients with oral lichen planus.

The degree of mental disturbance in 56 patients with clinically and histologically verified oral lichen planus (OLP) and in 44 non-OLP patients was investigated by means of the Cornell Medical Index psychological questionnaire. A statistically significant difference in mental disturbance between OLP patients and non-OLP patients was found, the OLP patients being more disturbed (p less than 0.01). The mental health of the non-OLP patients was equal to that of the general Finnish population. Of the OLP patients, 48.2% were mentally healthy, 21.4% had a mild mental disturbance, 5.4% had a moderate mental disturbance, and 25.0% had a severe mental disorder. The corresponding figures for the non-OLP patients were 72.7%, 9.1%, 11.4%, and 6.8%. Of the 56 OLP patients, 21 were randomly selected and referred for a psychiatric consultation. Five patients refused the psychiatric interview. Of the sixteen patients who were examined, five had a moderate psychiatric disorder, seven had a mild psychiatric disorder, one had signs of neurosis, and three were mentally healthy. Most of the patients had the subjective feeling that the clinical appearance of OLP, including discomfort, became worse during times of mental stress. None of the patients, however, had a subjective feeling of mental disturbance; nor did any of them feel any need for psychiatric treatment, except in one case.