Background. Glossodynia or burning mouth syndrome has been suggested to be a multifunctional disorder. Etiologic factors that have been reported include hematologic or vitamin deficiencies, denture factors, the climacteric, infections or endocrinological disorders. On the other hand psychological factors, such as anxiety, depression and phobias have been reported to play a significant role at the beginning of this nosological entity. It seems therefore that there are two main categories of glossodynia, one with a detectable organic etiology and another with a psychologic origin. The purpose of this study was to provide further information concerning the personality characteristics and the incidence of psychopathology in patients suffering from glossodynia without an organic etiology. Methods. Twenty-five patients suffering from glossodynia and 25 control subjects, matched for sex and age, participated in the study. Patients and controls were assessed concerning their psychosomatic morbidity. Both groups were given psychometric instruments (SRSD, STAI, EPQ, HDHQ, SSPS) for the assessment of personality characteristics and psychopathological symptoms. Results. Patients were significantly differentiated from controls with respect to all factors of HDHQ; they exhibited more hostility, either introverted or extroverted, than control subjects. The patients also had significantly higher values in the N (neuroticism) and the L (lie) factors of the EPQ. Concerning the other psychometric measurements there were no significant differences. Patients also had significantly higher rates of psychosomatic morbidity than controls. Conclusions. Our findings indicate that hostility – especially introverted hostility – neuroticism and possibly depression are important components of the psychological profile of patients suffering from glossodynia.

The periodically hyperactive hypothalamic-pituitaryadrenal (HPA) axis in bipolar affective disorders, as well as the reported changes in the binding characteristics of the glucocorticoid receptor (GR), suggest the possible involvement of the GR in the aetiopathology of this disease. This was investigated by screening the coding sequences of both GR isoforms, GR␣ and GR␤, for the presence of mutations. As a genetic predisposition has been implicated, we included in this study bipolar patients who were siblings. By RT-PCR of peripheral blood mononuclear cells from patients suffering from bipolar illness, using primers spanning the whole length of the GR␣ and GR␤ coding region and subsequent agarose gel electrophoresis, heteroduplex and sequence analyses, no GR mutations could be detected. Since glucocorticoid receptor activity can be modulated by agents other than the respective ligand (eg by growth factors, cytokines and stress signals), our results favor derangements in the modulation of GR activity by such agents and not in the primary structure of the receptor as aetiopathologic factors of bipolar disease. Molecular Psychiatry (2000) 5, 196-202.

Munchausen syndrome has been known since 1951. Its exact prevalence remains unknown, but it has been reported to be frequent among general hospital patients. We present the case of a 30-year-old female with a long history of inflammatory nodules and ulcerations all over her body. After a decade of repeated hospitalizations to general hospitals where no reason for these manifestations was clarified, her first admission to a psychiatric unit confirmed the artefact character of the lesions and led to milieu therapy in association with supportive, psychoanalytically orientated psychotherapy with a very positive outcome.

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