Psychiatric comorbidities and psychopharmacological outcomes of phantom bite syndrome

J Psychosom Res. 2015 Mar;78(3):255-9. doi: 10.1016/j.jpsychores.2014.11.010. Epub 2014 Nov 15.

Abstract

Objective: Phantom bite syndrome (PBS) is characterized by a persistent uncomfortable sensation of occlusion without an evident occlusal discrepancy. The aims of this retrospective cross-sectional study were to assess psychiatric comorbidities and evaluate psychopharmacological outcomes of PBS.

Methods: The database of the Psychosomatic Dentistry Clinic of Tokyo Medical and Dental University Dental Hospital was reviewed for cases of PBS diagnosed between April 2009 and March 2012. Clinical Global Impression indices were used to assess psychopharmacological outcomes.

Results: The review revealed 130 patients (107 women, 23 men) with a mean age of 53.0 ±13.1 years. They previously visited 4.4 ±3.4 dental clinicsand had a mean symptom duration of 5.3 ±5.4 years. Only 24 (18.5%) of 63 (48.5%) patients with psychiatric comorbidities had schizophrenia, major depressive disorder, or bipolar disorder. The frequency of psychiatric comorbidities was significantly lower in PBS with a dental trigger than that without a specific trigger. Moreover, patients without a psychiatric comorbidity showed significantly better outcomes than those with a psychiatric comorbidity. Forty patients (30.8%) showed remarkable clinical improvement after receiving amitriptyline, mirtazapine, or aripiprazole.

Conclusion: PBS is generally not associated with severe psychiatric disorders. Absence of a dental trigger predicts a psychiatric comorbidity, which affects the psychopharmacological outcome. Antidepressant or antipsychotic therapy may be effective for symptom management in PBS.

Keywords: Antidepressants; Dental treatment; Phantom bite syndrome; Psychiatric disorder; Psychopharmacology; Trigger.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents / therapeutic use*
  • Antipsychotic Agents / therapeutic use*
  • Bipolar Disorder / drug therapy
  • Bipolar Disorder / epidemiology
  • Comorbidity
  • Cross-Sectional Studies
  • Delusions / drug therapy*
  • Delusions / psychology*
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / epidemiology
  • Female
  • Humans
  • Male
  • Mental Disorders / drug therapy*
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Retrospective Studies
  • Schizophrenia / drug therapy
  • Schizophrenia / epidemiology
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Antipsychotic Agents