Amalgam Complaints Need Psychiatric Treatment

Discussion in 'Health and medical' started by Mark Thorson, Mar 21, 2004.

  1. Mark Thorson

    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.