Temperament and character profiles of patients with burning mouth syndrome Tatsuya Tokura a , Hiroyuki Kimura a, ⁎, Mikiko Ito b , Wataru Nagashima a , Naohiro Sato a , Yuki Kimura b , Munetaka Arao b , Branko Aleksic a , Keizo Yoshida c , Kenichi Kurita b , Norio Ozaki a a Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan b Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan c Health Care Promotion Division, Denso Corporation, Kariya, Japan abstract article info Article history: Received 10 October 2014 Received in revised form 11 February 2015 Accepted 12 February 2015 Keywords: Burning mouth syndrome (BMS) Pain disorder Personality trait Temperament and Character Inventory (TCI) Novelty seeking (NS) Beck Depression Inventory (BDI) Objective: Burning mouth syndrome (BMS) is a chronic disease in which patients feel a burning sensation and pain in the oral cavity. Although personality traits have been suggested to influence the development and course of BMS, they have not yet been examined in detail. We therefore investigated the personality traits of BMS patients. Methods: Sample consisted of 65 BMS patients presenting to the Aichi-Gakuin Dental School Hospital between May 2005 and April 2009. They were also diagnosed as having pain disorder by a psychiatrist. The control group consisted of 116 healthy subjects. The Temperament and Character Inventory (TCI) was used to evaluate personality traits, while the Beck Depression Inventory (BDI) was used to evaluate the depression rate in both groups. Results: In TCI, we found that, in comparison to the control group, the novelty seeking score was significantly lower (p = 0.009), the harm avoidance score was significantly higher (p b 0.001), and the self-directedness score was significantly lower (p = 0.039) in the BMS group. To remove the influence of depression, we performed an analysis of covariance of each TCI item using the BDI score as a covariate. No significant differences were observed in harm avoidance or self-directedness, whereas the differences noted in novelty seeking were significant (p = 0.008). Conclusion: The novelty seeking score was low in BMS patients in comparison to the control group. They also had high harm avoidance and low self-directedness tendencies, but these were attributed to the influence of depression. © 2015 Elsevier Inc. All rights reserved. Introduction Burning mouth syndrome (BMS) is a chronic disease that is charac- terized by a subjective burning sensation and pain in the oral mucosa [1]. BMS has been defined as a disease with a burning sensation and pain in the oral cavity, an abnormal sense of taste, and dry mouth despite no medical or dental cause being identified [2]. According to the diagnostic and statistical manual of mental disorders, 4th edition text revision (DSM-IV-TR) [3], the psychiatric diagnosis of BMS has been classified mainly as pain disorder. The prevalence of BMS was previously reported to be 0.7–4.6% [4–7], which revealed that the number of BMS patients was not small. BMS frequently develops in females aged 40–80 years, and the male:female ratio is approximately 1:7 [7]. Without treatment, only approximately 3% of cases achieved remission after 5 years [8,9]. Once the disease develops, symptoms persist for a long time. Thus, compared with the healthy people the quality of life (QOL) in patients with BMS is markedly impaired [10]. BMS is typically treated with antidepressants [11–13], antiepileptic drugs [14], and cogni- tive therapy [15]; however, no consensus has been reached regarding optimum treatment. Although the pathology of BMS remains unclear [16], its development is considered to involve psychosocial problems, including the following: difficult events in the home in childhood, insuffi- cient adaptation in school and at work, and discord in married or home life [17]. To improve the symptoms and QOL of BMS patients, physicians have to employ a bio-psycho-social approach, for which it is important to identify the personality traits involved in BMS because these may have a marked influence on the pathology and course of BMS [18]. The Temperament and Character Inventory (TCI), a self-rating scale developed by Cloninger et al. in 1993, is frequently used to assess Journal of Psychosomatic Research 78 (2015) 495–498 ⁎ Corresponding author at: Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi 466-8550, Japan. Tel.: +81 52 7442282; fax: +81 52 7442293. E-mail addresses: tatsuyatokura@gmail.com (T. Tokura), kimurahi@med.nagoya-u.ac.jp (H. Kimura), mi_ito1013@yahoo.co.jp (M. Ito), ooshiro9992000@yahoo.co.jp (W. Nagashima), satonao@med.nagoya-u.ac.jp (N. Sato), space-yuki0712@k4.dion.ne.jp (Y. Kimura), araoarao@hotmail.com (M. Arao), branko@med.nagoya-u.ac.jp (B. Aleksic), cxw01076@nifty.com (K. Yoshida), ken-kuri@dpc.agu.ac.jp (K. Kurita), ozaki-n@med.nagoya-u.ac.jp (N. Ozaki). http://dx.doi.org/10.1016/j.jpsychores.2015.02.006 0022-3999/© 2015 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Journal of Psychosomatic Research