口腔粘膜の異常感 : 舌痛症を中心に(<特集>歯科・口腔外科をめぐる心身医学)  [in Japanese] Oral Dysesthesia(<Special Issue>Psychosomatic Medicine in Dentistry and Oral Surgery)  [in Japanese]

精神医学的に患者の訴えに見合うだけの身体的所見が得られない症例は,心気症あるいはセネストパチーとして位置づけられるのが一般的であるが,その鑑別は容易でないことが多い.口腔異常感症は,この心気症に近縁の群とセネストパチー近縁の群に位置づけられることが多いが,一部にうつ病や統合失調症の随伴症状である場合があるので慎重な姿勢が大切である.舌痛症の疾病学的位置づけは,身体因が解明されていない現時点において,心理的側面は心気症に近縁な病態として理解可能である.本症の治療は,抗不安薬を中心にした薬物療法と精神療法が中心になるが,心気症に近縁の舌痛症は性格に起因する部分が多く対応に苦慮することが多い.

In general, from the standpoint of psychiatry, when the patient's complaint does not correspond with the physical examination, he/she is diagnosed as hypochondria or cenestopathia, but its discrimination is rather difficult. Oral dysesthesia is often placed in the group of hypochondria or in the group of cenestopathia, but part of its symptoms accompany those of depression or schizophrenia, so it requires very cautious treatment. With regard to the etiology of glossodynia, it is possible to consider that glossodynia is closely related with hypochondria, although its physical etiology is unknowm at present. The therapy of oral dysesthesia is consisted mainly of psychotherapy and medication which includes anti-anxiety agents. Because glossodynia is closely related with hypochondria, its symptoms are largely influenced by the character of the patient, which makes it difficult for us to treat them.