Emotional wellbeing, physical pain and doctor-patient relationship in patients hypersensitive to local anesthesia. Signs of somatization? A controlled cross-sectional study

Allergy-like symptoms resulting from the injection of local anesthetics, e. g. during dental treatment, that are reported by some patients, in most cas es cannot be explained by hypersensitivity to the anesthetics or preserving agents. It is suggested that these symptoms might be the result of somatiz ation. Ln the present cross-sectional controlled study, emotional state, ph ysical complaints and the doctor-patient-relationship are assessed among pa tients who presented with intolerance of local anesthetics in a dermatologi cal university department, as compared with patients suffering from allergy against insect toxins. The assessments were performed after the completion of the diagnostic evaluation, using both self-reports and interviewer rati ngs which were based on a structured interview. Whereas men and women were equally frequent in the comparison group, women by far overweighed men in t he intolerance group. Patients with intolerance of local anesthetics judged their doctor-patient relationships less favorable, had more unspecific phy sical symptoms, were more depressed (Hospital Anxiety and Depression Scale) and were rated by the interviewers to be emotionally more disturbed. Howev er, in the self-reports of anxiety no differences emerged. The results prov ide evidence for similarities to somatization disorders.