Yanan ağız sendromu ve depresyon: Bir olgu sunumu

Bu yazıda 63 yaşında, yakınmaları prostat ameliyatını takiben ortaya çıkan, bedensel belirtilerin ön planda olduğu ve ağız bölgesinde yoğunlaştığı psikotik özellikli major depresyon tanısı konan bir erkek olgu sunulmuştur. Olguda görülen ağızda yanma, ağrı, ağız kuruluğu, ağızda garip ve nahoş tat hissi, kaşınma vb. belirtiler yanan ağız sendromunda görülen belirtilerdir. Yanan ağız sendromu, ağız mukozasının klinik olarak normal olmasıyla birlikte başta dil olmak üzere ağız boşluğunda dayanılmaz olarak tanımlanan ağrı ve yanma duyumuyla belirli, yaygın görülen ve en sık ileri yaşlardaki kadınları etkileyen bir durumdur. Başlangıç, hastaların çoğunda kademeli bir şekilde olmaktadır. Hastaların çoğunda başlangıç belirtileri, geçmişteki tıbbi veya dişlerle ilgili işlemlerle bağlantılıdır. Yanan ağız sendromu multifaktöriyel etiyolojiye sahiptir. Bu duruma yol açan ruhsal etkenler arasında başta depresyon olmak üzere anksiyete bozulukları, hipokondriyazis, konversiyon bozukluğu vb. sayılabilir. Bu sendromun psikiyatrik yönü iyi bilinmemektedir. Psikiyatrik bozuklukların yanan ağız sendromuna eşlik eden bir durum mu olduğu yoksa ikisi arasında etiyolojik bir ilişki mi olduğu konusu tartışmalıdır. Bu hastalardaki ruhsal bulgular, kronik ağrı duyumunun nedeni veya sonucu olabilir. Ancak bilinen bir şey, bu hastaların şimdi veya geçmişte psikiyatrik tedavi görme oranlarının göreceli olarak daha yüksek olduğudur. Özellikle ağız yakınmaları olan yaşlılarda organik etiyoloji faktörleri dışlandıktan sonra depresyon akla gelmelidir.

Burning mouth syndrome and depression. A case report

We present a 63-year-old male patient with major depression, characterised by prominent somatic symptoms localised especially around the mouth, whose complaints started just after a prostate operation. The symptoms consisting of burning in the mouth, pain, dry mouth (xerostomia), an unpleasant and strange feeling of taste and itching, are all consistent with burning mouth syndrome. Burning mouth syndrome is a common disorder, usually affecting elderly females, characterised by intractable pain and burning in the oral cavity, evident especially in the tongue, together with a normal mouth mucosa. In the scientific literature a variety of terms are used to describe similar symptoms, such as glossodynia, glossopyrosis, stomatodynia and oral dysestesia. Most patients suffer from the syndrome for a long time, ranging from months up to years. The onset was reported to be gradual for most of the subjects, although many patients relate the onset of symptoms to previous dental procedures or to a previous medical illness. Burning mouth syndrome has a multifactorial etiology. Anxiety disorder, hypochondriasis, conversion disorder and especially depression may be considered amongst the psychological factors responsible for this situation. The psychological findings in burning mouth syndrome patients may be either the consequence of the chronic pain condition or its cause. It is well known that those patients had a relatively high percentage of psychiatric or psychological treatment in the past and/or present. After excluding organic factors, depression should be considered in old patients with predominant mouth complaints.

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