M
Mark Thorson
Guest
Psychother Psychosom 2002 Jul-Aug;71(4):223-32
Psychological, allergic, and toxicological aspects of
patients with amalgam-related complaints. Gottwald B, Kupfer
J, Traenckner I, Ganss C, Gieler U. Department of Medical
Psychology, University of Giessen, Germany.
Background: To deepen the understanding of the numerous
unspecific complaints which are related to the dental
material amalgam both in patients and physicians, an
interdisciplinary case-control study regarding
toxicological, allergic, psychological and psychiatric
aspects was conducted. Forty patients with amalgam-
associated complaints were compared to a well-matched group
of 40 amalgam bearers without complaints.
Methods: Patients and controls underwent a dental
examination, which included recording of the quantity,
surface area and quality of amalgam fillings, a
determination of the mercury load in blood and urine, an
allergy examination including patch testing with amalgam and
a psychometric assessment with questionnaires noting coping
strategies (ABI-UMW-P), interpersonal problems (Inventory of
Interpersonal Problems) and self-consciousness (SAM), the
NEO Five-Factor Inventory, Symptom Checklist-90-R, Beck
Depression Inventory and a screening instrument for
somatoform disorders.
Results: Patients and controls did not differ with respect
to mercury concentrations in body fluids. Only 1 patient
was found to have a positive amalgam patch test; various
other allergies could be determined in 28% of patients (n =
11). Patients had higher levels of psychic distress, a
higher incidence of depression and somatization disorders
as well as different styles of coping with anxiety compared
to controls.
Conclusions: No indication for mercury intoxication or
amalgam allergy as a cause of the patients' complaints could
be found. The theory of amalgam-related complaints as an
expression of underlying psychic problems is supported.
Treatment should focus on somatization and changing coping
and attribution styles.
Psychological, allergic, and toxicological aspects of
patients with amalgam-related complaints. Gottwald B, Kupfer
J, Traenckner I, Ganss C, Gieler U. Department of Medical
Psychology, University of Giessen, Germany.
Background: To deepen the understanding of the numerous
unspecific complaints which are related to the dental
material amalgam both in patients and physicians, an
interdisciplinary case-control study regarding
toxicological, allergic, psychological and psychiatric
aspects was conducted. Forty patients with amalgam-
associated complaints were compared to a well-matched group
of 40 amalgam bearers without complaints.
Methods: Patients and controls underwent a dental
examination, which included recording of the quantity,
surface area and quality of amalgam fillings, a
determination of the mercury load in blood and urine, an
allergy examination including patch testing with amalgam and
a psychometric assessment with questionnaires noting coping
strategies (ABI-UMW-P), interpersonal problems (Inventory of
Interpersonal Problems) and self-consciousness (SAM), the
NEO Five-Factor Inventory, Symptom Checklist-90-R, Beck
Depression Inventory and a screening instrument for
somatoform disorders.
Results: Patients and controls did not differ with respect
to mercury concentrations in body fluids. Only 1 patient
was found to have a positive amalgam patch test; various
other allergies could be determined in 28% of patients (n =
11). Patients had higher levels of psychic distress, a
higher incidence of depression and somatization disorders
as well as different styles of coping with anxiety compared
to controls.
Conclusions: No indication for mercury intoxication or
amalgam allergy as a cause of the patients' complaints could
be found. The theory of amalgam-related complaints as an
expression of underlying psychic problems is supported.
Treatment should focus on somatization and changing coping
and attribution styles.