{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:02:44Z","timestamp":1791525764589,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Oral Pathology Medicine"],"published-print":{"date-parts":[[2025,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n This study investigates how anxiety, depression, and sleep disturbances affect pain perception and clinical impairment in burning mouth syndrome (BMS).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross\u2010sectional survey was conducted on 200 BMS patients. The Hamilton Rating Scale for Depression (HAM\u2010D) and Anxiety (HAM\u2010A), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Visual Analogue Scale (VAS), and short form of McGill pain questionnaire (SF\u2010MPQ) were used. The Clinical Global Impressions Severity of Illness (CGI\u2010S) assessed illness severity, and comorbidities were analyzed via the Age\u2010Adjusted Charlson Comorbidity Index (AACCI). Correlation tests and path analyses explored relationships among psychological factors, sleep quality, and BMS severity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Pain intensity (VAS) correlated significantly with anxiety (HAM\u2010A,\n \u03c1<\/jats:italic>\n \u2009=\u20090.25,\n p<\/jats:italic>\n \u2009<\u20090.05), depression (HAM\u2010D,\n \u03c1<\/jats:italic>\n \u2009=\u20090.15,\n p<\/jats:italic>\n \u2009<\u20090.05), and shorter sleep duration (\n \u03c1<\/jats:italic>\n \u2009=\u2009\u22120.19,\n p<\/jats:italic>\n \u2009<\u20090.05). Path analyses revealed that anxiety significantly increased pain intensity (\n \u03b2<\/jats:italic>\n \u2009=\u20090.24,\n p<\/jats:italic>\n \u2009<\u20090.05), indirectly influencing clinical severity (CGI\u2010S:\n \u03b2<\/jats:italic>\n \u2009=\u20090.07,\n p<\/jats:italic>\n \u2009<\u20090.05). Depression strongly impacted poor sleep quality (PSQI,\n \u03b2<\/jats:italic>\n =\u20090.33,\n p<\/jats:italic>\n \u2009<\u20090.05). Shorter sleep duration affected both sleep quality (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.46,\n p<\/jats:italic>\n \u2009<\u20090.05) and clinical outcomes (CGI\u2010S,\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22120.17,\n p<\/jats:italic>\n \u2009<\u20090.05). Pain quality (SF\u2010MPQ) showed weaker, non\u2010significant associations with psychological factors.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Anxiety amplifies pain intensity, while depression worsens sleep quality, exacerbating clinical outcomes. Shorter sleep duration further contributes to worse outcomes. These findings emphasize the need for tailored interventions targeting psychological distress and sleep disturbances to improve pain management and quality of life in BMS patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jop.70026","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T04:10:08Z","timestamp":1754971808000},"page":"807-822","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Inside the Fire. Exploring the Impact of Anxiety, Depression, and Sleep Disturbances on Pain Perception in Burning Mouth Syndrome: A Cross\u2010Sectional Study of\u00a0200 Patients"],"prefix":"10.1111","volume":"54","author":[{"given":"Antonietta","family":"Argiuolo","sequence":"first","affiliation":[{"name":"Intradepartmental Program of Clinical Psychopathology Federico II University Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Canfora","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Odontostomatology University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0299-497X","authenticated-orcid":false,"given":"Benedetta","family":"Muzii","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Odontostomatology University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"D'Antonio","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, School of Dentistry University Magna Graecia of Catanzaro Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"D'Auria","sequence":"additional","affiliation":[{"name":"Intradepartmental Program of Clinical Psychopathology Federico II University Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amerigo","family":"Giudice","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, School of Dentistry University Magna Graecia of Catanzaro Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3576-4670","authenticated-orcid":false,"given":"Gennaro","family":"Musella","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1019-9212","authenticated-orcid":false,"given":"Luca","family":"D'Aniello","sequence":"additional","affiliation":[{"name":"Department of Economics and Statistics University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Aria","sequence":"additional","affiliation":[{"name":"Department of Economics and Statistics University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson Mauro","family":"Maldonato","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Odontostomatology University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele Davide","family":"Mignogna","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Odontostomatology University of Naples \u201cFederico II\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3784-4229","authenticated-orcid":false,"given":"Daniela","family":"Adamo","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Odontostomatology University of Naples \u201cFederico II\u201d Naples Italy"},{"name":"Department of Life Science, Health, and Health Professions Link Campus University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20010682"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102416646769"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13136"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.13868"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2023.10.002"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-53074-4"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dentre.2022.100036"},{"issue":"1","key":"e_1_2_12_9_1","first-page":"9","article-title":"Understanding of Burning Mouth Syndrome Based on Psychological Aspects","volume":"21","author":"Kim M. 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