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.
Highlights
Chronic pain is generally understood in the biopsychosocial context
In a seminal study on chronic pain patients, increasing pain intensity and interference was associated with increased psychosocial impairment and predicted the long-term pain status.[6]
Burning mouth syndrome (BMS) is a chronic, debilitating oro-facial pain condition that is defined by a burning sensation of the oral mucosa without any identifiable oral lesions or other pathology to explain the symptoms.[11,12]
Summary
Chronic pain is generally understood in the biopsychosocial context. It is a multidimensional phenomenon, where psychological factors and other comorbidities such as sleep disturbances and other pain problems influence pain experience, complicate treatment outcome and contribute to chronicity.[1,2] During recent years, much effort has been put into developing classification systems to help to capture the multidimensional character of chronic pain with the purpose, among others, improving the prognostic judgments. Burning mouth syndrome (BMS) is a chronic, debilitating oro-facial pain condition that is defined by a burning sensation of the oral mucosa without any identifiable oral lesions or other pathology to explain the symptoms.[11,12] The etiopathogenesis of BMS has long been considered enigmatic, but today several lines of evidence suggest a neuropathologic background for the symptoms.[13,14] Oral pain presents the cardinal symptom of BMS It is usually described as burning in quality[15] and as mild to severe in intensity.[16] The findings from a pain diary study demonstrated, in addition to some diurnal pain variation, a considerable inter-individual variation in the intensity The specific aim was to study whether patients reporting most intensive and interfering pain differ from those with less severe pain symptoms
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