Regular Article

Psychological, Allergic, and Toxicological Aspects of Patients with Amalgam-Related Complaints
Birgit Gottwald^a, Jörg Kupfer^a, Isabel Traenckner^b, Carolina Ganss^c, Uwe Gieler<sup>d

a</sup>Department of Medical Psychology,
^bCenter of Dermatology and Andrology,
^cDental Clinic, Department of Operative and Preventive Dentistry,
^dCenter of Psychosomatic Medicine, University of Giessen, Germany

Address of Corresponding Author

Psychother Psychosom 2002;71:223-232 (DOI: 10.1159/000063648)

  Key Words

• Mercury
• Amalgam-related complaints
• Allergy
• Somatization
• Depression
• Coping

  Abstract

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.

Copyright © 2002 S. Karger AG, Basel

  Author Contacts

Dr. J. Kupfer
Department of Medical Psychology
Friedrichstrasse 36, D-35392 Giessen (Germany)
Tel. +49 641 9945684, Fax +49 641 9945689
E-Mail joerg.p.kupfer@psycho.med.uni-giessen.de

  Article Information

Number of Print Pages : 10
Number of Figures : 0, Number of Tables : 7, Number of References : 44