Oral Dysesthesia Rating Scale: a tool for assessing psychosomatic symptoms in oral regions

BMC Psychiatry

Toru Nishikawa¹  Akeo Kurumaji¹  Naoki Yamamoto¹  Makoto Tomita²  Akira Toriihara⁴  Motoko Watanabe⁶  Yojiro Umezaki⁵  Akira Toyofuku⁶  Akihito Uezato³ 

[1] Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;Clinical Research Center, Tokyo Medical and Dental University Hospital Faculty of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, 1713 6th Avenue South, Birmingham 35294, AL, USA;Department of Diagnostic Radiology and Oncology, Tokyo Dental and Medical University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston 29425, SC, USA;Section of Psychosomatic Dentistry, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan

关键词: Oral DRS;    Reliability;    Validity;    Delusional parasitosis;    Somatoform disorder;    Somatic-type delusional disorder;    Cenesthopathy;   

Others  :  1091093
DOI  :  10.1186/s12888-014-0359-8

 received in 2014-09-14, accepted in 2014-12-11,  发布年份 2014

【 摘 要 】

Background

The concept of cenesthopathy was first introduced by Dupré and Camus in 1907 to describe clinically unexplainable bodily sensations mainly attributed to psychiatric pathology. If it occurs in oral regions, it is termed oral cenesthopathy and it has been of special interest to psychiatrists and dentists. While there is no independently defined criteria for this condition, which is classified as either a delusional or a somatoform disorder, clinical practice and research require a standard scale to measure and rate its symptoms. In this study, we included any types of psychosomatic symptoms in oral regions as oral dysesthesia, and developed an Oral Dysesthesia Rating Scale (Oral DRS) and evaluated its validity and reliability as an assessment tool.

Methods

The scale was developed based on literature review and extensive clinical experience. Twelve reviewers assessed relevancy of each item to oral dysesthesia symptoms by 1–4 scoring scale and item content validity index was computed. To evaluate the inter-rater reliability of Oral DRS, pairs of raters administered the scale to 40 randomly selected patients with complaints of oral dysesthesia symptoms and Cohen’s weighted kappa coefficient was determined for each item.

Results

The scale assesses the severity of feelings of foreign body [A1], exudation [A2], squeezing-pulling [A3], movement [A4], misalignment [A5], pain [A6], and spontaneous thermal sensation or tastes [A7], and the degree of impairment in eating [B1], articulation [B2], work [B3], and social activities [B4] on a scale of 0–5. Items A1, A2, A3, A4, B3, and B4 demonstrated acceptable content validity. Inter-rater reliabilities were good or excellent for all items evaluated.

Conclusion

The Oral DRS can help define the nosography of clinically unexplainable oral dysesthesia through further case evaluation and clinical research and facilitate devising of treatment modalities.

【 授权许可】

   
2014 Uezato et al.; licensee Biomed Central.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Dupré E, Camus P: Les cénesthopathies. Encéphale 1907, 2:616-631.
• [2]Graux J, Lemoine M, Gaillard P, Camus V: Cenesthopathies: a disorder of background emotions at the crossroads of the cognitive sciences and phenomenology. Encéphale 2011, 37(5):361-370.
• [3]Hozaki H, Takahashi Y, Nakamura N, Kaizawa S: On chronic sensory hallucination. Seishin Igaku (in Japanese) 1959, 1:391-396.
• [4]Honma F, Kimura M, Endo S, Ohtsu M, Okada T, Satoh T: Oral cenesthopathy examined by Rorschach test. Psychiatry Clin Neurosci 2006, 60(2):154-159.
• [5]Wake Y, Fujiwara Y, Aoki S, Kuroda S: Clinical character of cenesthopathy located in oral cavity. Seishin Igaku (in Japanese) 1998, 40(4):437-440.
• [6]Yoshimatsu K: Recent nosological consideration of cenesthopathy and the therapy. Jpn J Psychiatr Treat (in Japanese) 1996, 11(12):1285-1292.
• [7]Uezato A, Yamamoto N, Kurumaji A, Toriihara A, Umezaki Y, Toyofuku A, Nishikawa T: Improvement of asymmetrical temporal blood flow in refractory oral somatic delusion after successful electroconvulsive therapy. J ECT 2012, 28(1):50-51.
• [8]Takahashi T: A review of recent case reports of cenesthopathy in Japan. Psychogeriatrics 2013, 13(3):196-198.
• [9]Umezaki Y, Katagiri A, Watanabe M, Takenoshita M, Sakuma T, Sako E, Sato Y, Toriihara A, Uezato A, Shibuya H, Nishikawa T, Motomura H, Toyofuku A: Brain perfusion asymmetry in patients with oral somatic delusions. Eur Arch Psychiatry Clin Neurosci 2013, 263(4):315-323.
• [10]Ueda S, Marutani T, Okubo Y: Cenesthopathy in the presenium associated with manic factor resolved with lithium carbonate: two female cases with underlying manic or mixed state. Seishin Shinkeigaku Zasshi (in Japanese) 2013, 115(2):127-138.
• [11]Miyaoka H, Kamijima K, Katayama Y, Ebihara T, Nagai T: A psychiatric appraisal of “glossodynia”. Psychosomatics 1996, 37(4):346-348.
• [12]Miyaoka H: Cenestopathy in and around the mouth. Jpn J Psychiatr Treat (in Japanese) 1997, 12(4):347-355.
• [13]Hozaki H: Cénestopathia and related condition. Seishin Igaku (in Japanese) 1960, 2:325-332.
• [14]Ota M, Mizukami K, Katano T, Sato S, Takeda T, Asada T: A case of delusional disorder, somatic type with remarkable improvement of clinical symptoms and single photon emission computed tomograpy findings following modified electroconvulsive therapy. Prog Neuropsychopharmacol Biol Psychiatry 2003, 27(5):881-884.
• [15]Hayashi H, Oshino S, Ishikawa J, Kawakatsu S, Otani K: Paroxetine treatment of delusional disorder, somatic type. Hum Psychopharmacol 2004, 19(5):351-352.
• [16]Akahane T, Hayashi H, Suzuki H, Kawakatsu S, Otani K: Extremely grotesque somatic delusions in a patient of delusional disorder and its response to risperidone treatment. Gen Hosp Psychiatry 2009, 31(2):185-186.
• [17]Lynn MR: Determination and quantification of content validity. Nurs Res 1986, 35(6):382-385.
• [18]Polit DF, Beck CT: Nursing Research: Generating and Assessing Evidence for Nursing Practice. 9th Edition. Lippincott Williams & Wilkins; 2011.
• [19]Cohen J: Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 1968, 70(4):213-220.
• [20]Cohen J: A Coefficient of Agreement for Nominal Scales. Educ Psychol Meas 1960, 20(1):37-46.
• [21]Kramer MS, Feinstein AR: Clinical biostatistics. LIV. The biostatistics of concordance. Clin Pharmacol Ther 1981, 29(1):111-123.
• [22]Freudenmann RW, Lepping P: Delusional infestation. Clin Microbiol Rev 2009, 22(4):690-732.
• [23]Hamilton M: A rating scale for depression. J Neurol Neurosurg Psychiatry 1960, 23:56-62.