高齢者歯科外来における2017，2018年度の歯科心身症患者153名の臨床統計的検討

The importance of patients’ biopsychosocial evaluation has been advocated since the Japanese Society of Psychosomatic Dentistry was established. Several studies have showed the possibility of treating oral psychosomatic disorders （OPD）, which seemed to be intractable for a long time. However, in the clinical setting of community-based dental health care, many dentists still regard patients with OPD as troublesome. Even when patients are referred to psychiatrists, some of them tend to refuse, and instead continue seeking an organic cause, resulting in so-called “doctor shopping.” Amid this situation, core hospitals for OPD are needed. In this study, we retrospectively reviewed the patients with oral psychosomatic disorder in our clinic. <br>A total of 153 patients （34 males, 119 females） who came to our clinic from April 2017 to March 2018 （2 years） were included in this study. We collected their demographic data, medical history, psychological background, detailed diagnosis for OPD and treatment outcome. Additionally, we identified the factors for good clinical outcomes using logistic regression analysis. <br>The mean age was 64 years old and duration of illness was 24 months. The total number of patients with OPD in 2018 was 99, which was as almost twice that in 2017. Burning mouth syndrome, oral cenesthopathy, atypical odontalgia and phantom bite syndrome were seen in 112 （66％）, 29 （17％）, 20 （12％） and 5 （3％） cases, respectively. Seventy of the cases were referred from dental hospitals and clinics. As to medical history, cardiovascular disorder, digestive disorder, and nervous system disorder were seen in 68 （44％）, 64 （42％）, and 57 （37％） cases, respectively. Depression was seen in 28 cases （18％）, and schizophrenia in one case. An examination of biopsychosocial background revealed insomnia in 135 cases （88％）. Suicidal ideation was seen in 45 cases, but they were not severe except for one case who was undergoing treatment for severe depression in a psychiatric hospital. Logistic regression analysis revealed that the duration of illness was a significant predictor for good outcome. Early detection and treatment may lead to a better prognosis of OPD. <br>This study showed the potential large demand for OPD in community-based dental health care. It is necessary to provide a medical system for OPD patients and to better educate dentists about OPD.