{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:36:41Z","timestamp":1783985801487,"version":"3.55.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["17K09029"],"award-info":[{"award-number":["17K09029"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["22K10141"],"award-info":[{"award-number":["22K10141"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:p>Chronic pain has recently been associated with developmental disorders [autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD)]. Regarding chronic pain in adulthood, fibromyalgia, migraine, and chronic low back pain have been associated with ADHD. The ICD-11 disease classification categorizes these pain diseases as chronic primary pain, suggesting high comorbidity with developmental disorders in chronic primary pain. Atypical odontalgia (AO) is a persistent tooth pain that occurs in the absence of any of the usual dental causes, most of which are triggered by dental treatment. Conditions characterized by tooth pain with no apparent cause are also classified as chronic primary pain. Approximately half the patients with AO are diagnosed with psychiatric disorders; the most common are depression (15.4%) and anxiety disorders (10.1%). However, there are no reports on neurodevelopmental disorders comorbid with AO. In the present study, we report a case of a 46-year-old man with numerous complaints (e.g., occlusal instability, difficulty eating, difficulty speaking), who took work leave due to worsening of his symptoms after periodontal scaling (\u201cgingival recession\u201d and \u201caggressive periodontal treatment\u201d) and frequently expressed dissatisfaction and anger at the hospital, making the dental treatment difficult. After a referral to a psychiatrist specializing in chronic pain, AO and previously undiagnosed comorbidity of ASD and ADHD were confirmed. Atypical antipsychotic risperidone for ASD irritability and an ADHD medication, atomoxetine dramatically reduced anger, pain, anxiety, depression, and pain catastrophizing thoughts, leading to reduced obsession with his symptoms and less frequent complaints. After risperidone (1 mg\/day) + atomoxetine (120 mg\/day) were ultimately prescribed after adjustment, he was able to return to work 226 days after initiation of psychiatric treatment. Recent studies show that comorbidity of developmental disorders in patients with chronic pain is likely to be undetected. Clinicians should include screening for ASD and ADHD not only in cases of fibromyalgia, migraine, and chronic low back pain, but also in orofacial pain such as AO and other treatments for chronic primary pain. For patients diagnosed with ASD or ADHD, an effective drug therapy for ASD and ADHD should be considered.<\/jats:p>","DOI":"10.3389\/fpain.2022.926946","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T06:00:08Z","timestamp":1658469608000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Case report: Treatment of persistent atypical odontalgia with attention deficit hyperactivity disorder and autism spectrum disorder with risperidone and atomoxetine"],"prefix":"10.3389","volume":"3","author":[{"given":"Satoshi","family":"Kasahara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chihiro","family":"Takao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Matsudaira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trang Thi Huyen","family":"Tu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Ichi","family":"Niwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanji","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Toyofuku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.jpsychores.2017.11.001","article-title":"Psychiatric comorbidities in patients with atypical odontalgia","volume":"104","author":"Miura","year":"2018","journal-title":"J Psychosom Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.sjpain.2011.06.004","article-title":"Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain","volume":"2","author":"Taiminen","year":"2011","journal-title":"Scand J Pain."},{"key":"B3","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1177\/070674378302800304","article-title":"Psychiatric disorders associated with atypical facial pain","volume":"28","author":"Remick","year":"1983","journal-title":"Can J Psychiatry."},{"key":"B4","volume-title":"Section II: Diagnostic Criteria and Codes. Diagnostic and Statistical Manual of Mental Disorders. 5th ed","year":"2013"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2827","DOI":"10.2147\/JPR.S177534","article-title":"Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain","volume":"11","author":"Lipsker","year":"2018","journal-title":"J Pain Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2925","DOI":"10.2147\/JPR.S212422","article-title":"Chronic pain and health-related quality of life in women with autism and\/or ADHD: a prospective longitudinal study","volume":"12","author":"Aszt\u00e9ly","year":"2019","journal-title":"J Pain Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.2147\/NDT.S159312","article-title":"Attention-deficit hyperactivity disorder and impulsivity in female patients with fibromyalgia","volume":"14","author":"Yilmaz","year":"2018","journal-title":"Neuropsychiatr Dis Treat."},{"key":"B8","first-page":"165","article-title":"ADHD and fibromyalgia: related conditions?","volume-title":"The Complete Guide from Medical Experts and Patients","author":"Young","year":"2007"},{"key":"B9","first-page":"118","article-title":"Fibromyalgia, chronic fatigue, and adult attention deficit hyperactivity disorder in the adult: a case study","volume":"40","author":"Young","year":"2007","journal-title":"Psychopharmacol Bull."},{"key":"B10","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1097\/PSY.0000000000000947","article-title":"Pain and attention-deficit\/hyperactivity disorder: the case of margaret mitchell","volume":"83","author":"Kasahara","year":"2021","journal-title":"Psychosom Med."},{"key":"B11","first-page":"127","article-title":"Distraction as a key determinant of impaired memory in patients with fibromyalgia","volume":"33","author":"Leavitt","year":"2006","journal-title":"J Rheumatol."},{"key":"B12","first-page":"S141","article-title":"High frequency of adult attention deficit hyperactivity disorder among fibromyalgia patients in the Netherlands: should a systematic collaboration between rheumatologists and psychiatrists be sought?","volume":"33","author":"Derksen","year":"2015","journal-title":"Clin Exp Rheumatol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/j.eurpsy.2010.03.012","article-title":"High frequency of childhood ADHD history in women with fibromyalgia","volume":"26","author":"Reyero","year":"2011","journal-title":"Eur Psychiatry."},{"key":"B14","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1007\/s00787-017-1045-4","article-title":"is associated with migraine: a systematic review and meta-analysis","volume":"27","author":"Salem","year":"2018","journal-title":"Eur Child Adolesc Psychiatry."},{"key":"B15","doi-asserted-by":"publisher","first-page":"E299","DOI":"10.36076\/ppj.2021\/24\/E299","article-title":"High attention-deficit\/hyperactivity disorder scale scores among patients with persistent chronic nonspecific low back pain","volume":"24","author":"Kasahara","year":"2021","journal-title":"Pain Physician."},{"key":"B16","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s43166-022-00124-2","article-title":"Central sensitization and adult attention deficit hyperactivity disorder in medical students with chronic back pain: a cross-sectional study","volume":"49","author":"Ibrahim","year":"2022","journal-title":"Egypt Rheumatol Rehabil"},{"key":"B17","unstructured":"Revision of the International Classification of Diseases (ICD-11)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1177\/0333102417706349","article-title":"Persistent idiopathic facial pain","volume":"37","author":"Benoliel","year":"2017","journal-title":"Cephalalgia."},{"key":"B19","doi-asserted-by":"publisher","first-page":"81","DOI":"10.3238\/arztebl.m2021.0006","article-title":"Idiopathic facial pain syndromes\u2013an overview and clinical implications","volume":"118","author":"Ziegeler","year":"2021","journal-title":"Dtsch Arztebl Int."},{"key":"B20","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s13030-017-0106-8","article-title":"Clinical features of atypical odontalgia; three cases and literature reviews","volume":"11","author":"Takenoshita","year":"2017","journal-title":"Biopsychosoc Med."},{"key":"B21","first-page":"22","article-title":"The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10","volume":"59","author":"Sheehan","year":"1998","journal-title":"J Clin Psychiatry"},{"key":"B22","volume-title":"Conners' Adult ADHD Rating Scale (CAARS) Technical Manual.","author":"Conners","year":"1999"},{"key":"B23","volume-title":"Diagnostic Interview for ADHD in Adults 2.0 (DIVA 2.0).","author":"Kooij","year":"2010"},{"key":"B24","first-page":"19","article-title":"Self-report scales and procedures for assessing pain in adults","volume-title":"Handbook of Pain Assessment.","author":"Jensen","year":"2011"},{"key":"B25","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand."},{"key":"B26","doi-asserted-by":"publisher","first-page":"524e532","DOI":"10.1037\/1040-3590.7.4.524","article-title":"The pain catastrophizing scale: development and validation","volume":"7","author":"Sullivan","year":"1995","journal-title":"Psychol Assess."},{"key":"B27","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.ejpain.2003.09.004","article-title":"Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale","volume":"8","author":"Salaffi","year":"2004","journal-title":"Eur J Pain."},{"key":"B28","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/1477-7525-6-46","article-title":"The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease","volume":"6","author":"Puhan","year":"2008","journal-title":"Health Qual Life Outcomes."},{"key":"B29","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1097\/00002508-200103000-00008","article-title":"Theoretical perspectives on the relation between catastrophizing and pain","volume":"17","author":"Sullivan","year":"2001","journal-title":"Clin J Pain."},{"key":"B30","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1097\/AJP.0b013e31828eee6c","article-title":"Clinically meaningful scores on pain catastrophizing before and after multidisciplinary rehabilitation: a prospective study of individuals with subacute pain after whiplash injury","volume":"30","author":"Scott","year":"2014","journal-title":"Clin J Pain."},{"key":"B31","doi-asserted-by":"publisher","first-page":"PCC","DOI":"10.4088\/PCC.13r01600","article-title":"Underdiagnosis of attention-deficit\/hyperactivity disorder in adult patients: a review of the literature","volume":"16","author":"Ginsberg","year":"2014","journal-title":"Prim Care Companion CNS Disord."},{"key":"B32","doi-asserted-by":"publisher","first-page":"162","DOI":"10.3810\/pgm.2013.01.2631","article-title":"Chronic fatigue syndrome: 3 cases and a discussion of the natural history of attention-deficit\/hyperactivity disorder","volume":"125","author":"Young","year":"2013","journal-title":"Postgrad Med."},{"key":"B33","unstructured":"Atomoxetine\n            FedderD\n            PatelH\n            SaadabadiA\n          Treasure Island, FLStatPearls PublishingStatPearls.2022"},{"key":"B34","volume-title":"Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 4th ed.","author":"Stahl","year":"2013"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1037\/0033-295X.114.4.1047","article-title":"Stimulus-dependent dopamine release in attention-deficit\/hyperactivity disorder","volume":"114","author":"Sikstr\u00f6m","year":"2007","journal-title":"Psychol Rev."},{"key":"B36","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1097\/PSY.0000000000000789","article-title":"Attention-deficit\/hyperactivity disorder and chronic pain","volume":"82","author":"Kasahara","year":"2020","journal-title":"Psychosom Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1873","DOI":"10.1016\/j.euroneuro.2014.09.013","article-title":"Effectiveness of one-year pharmacological treatment of adult attention-deficit\/hyperactivity disorder (ADHD): an open-label prospective study of time in treatment, dose, side-effects and comorbidity","volume":"24","author":"Fredriksen","year":"2014","journal-title":"Eur Neuropsychopharmacol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1177\/0269881120972336","article-title":"Pharmacotherapy of attention deficit\/hyperactivity disorder in individuals with autism spectrum disorder: a systematic review of the literature","volume":"35","author":"Joshi","year":"2021","journal-title":"J Psychopharmacol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"110326","DOI":"10.1016\/j.pnpbp.2021.110326","article-title":"The pediatric psychopharmacology of autism spectrum disorder: a systematic review - Part I: The past and the present","volume":"110","author":"Persico","year":"2021","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry."},{"key":"B40","first-page":"268","volume-title":"Chronic Pain: An Integrated Biobehavioral Approach","author":"Flor","year":"2011"},{"key":"B41","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1080\/00325481.2016.1147925","article-title":"Psychopharmacology of chronic pain: a focus on antidepressants and atypical antipsychotics","volume":"128","author":"Khouzam","year":"2016","journal-title":"Postgrad Med."},{"key":"B42","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1001\/archpsyc.55.7.633","article-title":"double-blind, placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders","volume":"55","author":"McDougle","year":"1998","journal-title":"Arch Gen Psychiatry."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1001\/jama.2011.1360","article-title":"Efficacy and comparative effectiveness of atypical antipsychotic medications for off-label uses in adults: a systematic review and meta-analysis","volume":"306","author":"Maher","year":"2011","journal-title":"JAMA."},{"key":"B44","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s12916-020-01585-y","article-title":"Guidance for identification and treatment of individuals with attention deficit\/hyperactivity disorder and autism spectrum disorder based upon expert consensus","volume":"18","author":"Young","year":"2020","journal-title":"BMC Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1111\/joor.12256","article-title":"An update on pathophysiological mechanisms related to idiopathic oro-facial pain conditions with implications for management","volume":"42","author":"Forssell","year":"2015","journal-title":"J Oral Rehabil."}],"container-title":["Frontiers in Pain Research"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2022.926946\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T06:00:21Z","timestamp":1658469621000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2022.926946\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,22]]},"references-count":45,"alternative-id":["10.3389\/fpain.2022.926946"],"URL":"https:\/\/doi.org\/10.3389\/fpain.2022.926946","relation":{},"ISSN":["2673-561X"],"issn-type":[{"value":"2673-561X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,22]]},"article-number":"926946"}}