Case Report Suicidal Behavior in a Patient with Burning Mouth Syndrome Konstantinos Kontoangelos, 1,2 Evmorfia Koukia, 3 Vasilis Papanikolaou, 4 Aris Chrysovergis, 4 Antonis Maillis, 1,2 and George N. Papadimitriou 1 1 1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, 115 28 Athens, Greece 2 University Research Institute of Mental Health, 11527 Athens, Greece 3 Department of Mental Health and Behavioral Sciences, Faculty of Nursing, University of Athens, 11527 Athens, Greece 4 1st University Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration Hospital, Athens University, 11527 Athens, Greece Correspondence should be addressed to Konstantinos Kontoangelos; kontange@hol.gr Received 17 June 2014; Accepted 17 August 2014; Published 26 August 2014 Academic Editor: Tomas Frodl Copyright © 2014 Konstantinos Kontoangelos et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Chronic pain of the oral cavity is a long-term condition and like all other types of chronic pain is associated with numerous comorbidities such as depression or anxiety. Case Presentation. Tis is a case of a 93-year-old patient sufering from chronic oral cavity pain who repeatedly stabbed his palate due to ongoing local pain, over the last few months, which he could not further tolerate. Te patient was sufering from depression and also a diagnosis of “burning mouth syndrome” (BMS) was made. Discussion. Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites. BMS has high psychiatric comorbidity but can occur in the absence of psychiatric diagnosis. Patients with multiple forms of pain must be considered as potential candidates for underdiagnosed depression (major) and suicidal thoughts. 1. Introduction Te multidimensionality of chronic pain of the oral cav- ity is connected with psychosocial factors. Many patients will have more than one pain diagnosis and there may also be an underlying psychiatric or personality disorder which predisposes to chronic pain and which may modify clinical course that ofen leads to false management [1]. Chronic oral pain is related with posttraumatic trigeminal neuropathy, trigeminal neuralgia, persistent idiopathic facial pain, trigeminal postherpetic neuralgia, temporomandibular disorders, and burning mouth syndrome [2]. Burning mouth syndrome has been defned as burning pain in the tongue or oral mucous membranes, usually without accompanying clinical and laboratory fndings. Pain is absent during the night but occurs at a mild to moderate level by middle to late morning. Patients ofen report that the pain interferes with their ability to fall asleep. Sleep disorder and constant pain alone or together coexist with disturbances, that is, irritability, anxiety, and depression. Epidemiological studies on BMS have shown a prevalence of 2.6% to 5.1% and that the ratio of occurrence of the disorder in men is less than 20% of that in women [3]. Concerning the etiology of BMS, it has been suggested that the etiological factors can be divided into three main groups: local, systemic, and psychogenic [4]. In the genesis of BMS, the possible role of stressful life events and of long-term social problems and also that 50% of the cases of BMS are comorbid with other current psychiatric disorders. Depressive symptoms (major depressive episode and dysthymic disorder) represent the most prevalent concurrent (32.3%) and lifetime (36.3%) codiagnoses. In most cases afer the frst episode of BMS a major depressive episode alone or together with GAD follows, suggesting a precipitating role in the onset of these disorders [5]. We present a case of a patient sufering from chronic oral pain who repeatedly stabbed his palate due to ongoing local pain, over the last few months, which he could not any more tolerate. Hindawi Publishing Corporation Case Reports in Psychiatry Volume 2014, Article ID 405106, 3 pages http://dx.doi.org/10.1155/2014/405106