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. 2018 Aug 13:14:2057-2065.
doi: 10.2147/NDT.S167527. eCollection 2018.

Clinical characteristics and course of oral somatic delusions: a retrospective chart review of 606 cases in 5 years

Yojiro Umezaki  1 , Anna Miura  2 , Yukiko Shinohara  2 , Lou Mikuzuki  2 , Shiori Sugawara  2 , Kaoru Kawasaki  2 , Trang Th Tu  2 , Takeshi Watanabe  2 , Takayuki Suga  2 , Motoko Watanabe  3 , Miho Takenoshita  2 , Tatsuya Yoshikawa  2 , Akihito Uezato  4 , Toru Nishikawa  4 , Ken Hoshiko  5 , Toru Naito  1 , Haruhiko Motomura  2 , Akira Toyofuku  2
Affiliations

Clinical characteristics and course of oral somatic delusions: a retrospective chart review of 606 cases in 5 years

Yojiro Umezaki et al. Neuropsychiatr Dis Treat. .

Abstract

Objective: Oral cenesthopathy is characterized by foreign body sensations without medical and dental evidence for them. It is thought to be a rare disease in psychiatry, but many patients are visiting dental clinics seeking treatment to remove a foreign body. Even though the features of oral cenesthopathy might be different between a psychiatric clinic and a dental clinic, there has been no clinic-statistical study from dentists. In this study, we report a clinico-statistical study of patients with oral cenesthopathy in dentistry.

Methods: This is a retrospective chart review of 606 outpatients with oral cenesthopathy in Tokyo Medical and Dental University from April 2010 through to March 2015.

Results: A total of 159 male and 447 female patients were included in this study. The mean age was 62.08 years, and female patients were older than male patients. The trigger of the dental treatment and the acute phase of depression at the onset were significantly related (p=0.037). Only 128 patients (36%) had clinically significant improvement after 6 months of pharmacotherapy. No history of psychiatric disorders (odds ratio [OR] 0.479 [95% confidence interval {CI}: 0.262-0.875], p=0.017) and longer duration of illness (>18 months) (OR 2.626 [95% CI: 1.437-4.799], p=0.002) were significant factors for clinical outcomes.

Conclusion: Patients with oral cenesthopathy in our clinic were predominantly elderly female patients. Dental treatment in the acute phase of depression might be a risk factor for oral cenesthopathy. Therefore, comprehending the situation of psychiatric disorder and obtaining adequate informed consent might be required to prevent the trouble concerning oral cenesthopathy.

Keywords: DDST; chart review; delusional disorder somatic type; dentistry; oral cenesthopathy.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
“Specimen sign” of a patient with oral cenesthopathy. Notes: (A) “Sticky liquid’’ coming from the patient’s palate was collected in a bottle and brought to our clinic. (B) “White powder from the gum of the upper jaw’’ was brought to show on the black plastic case, after drying his saliva.
Figure 2
Figure 2
Distribution of male and female patients. Notes: White and gray bars show the numbers of male and female patients, respectively. The numbers of patients in each age group are described beside the bars. The distributions are mono-modal with the peak in their 60s in both the patients.
Figure 3
Figure 3
State of depression at the onset of oral cenesthopathy. Notes: The number of patients with oral cenesthopathy after depression was 120 (77%). Eighteen patients developed depression after the onset of oral cenesthopathy. Simultaneous onset of oral cenesthopathy and depression was seen in 2%.
Figure 4
Figure 4
Course of oral cenesthopathy after 6 months of treatment using the clinical global impression improvement score. Notes: A total of 352 patients were followed up over 6 months. Only 128 patients (36%) had a clinically significant improvement.
See this image and copyright information in PMC

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