engleski

Psychological status in patients with temporomandibular disorders

Studies have indicated that patients with TMD demonstrate increased somatization, stress, anxiety, and depression relative to healthy individuals, and a consistent relationship has been demonstrated among anxiety, general somatic complaints, and TMD-related pain. The objectives of this study were to determine the differernces in depression and somatization in patients in different RDC/TMD axis I diagnostic groups and to investigate the role of psychological factors in TMD. The RDC/TMD is divided into 2 axes. Axis I involves the clinical TMD conditions, and axis II involves the pain-related disability and psychological status. One hundred fifty-four patients (37 male and 117 female ; mean age, 39.0 +/- 14.5 years) with RDC/TMD-defined clinical TMD were selected. Patients were subsequently classified into 7 groups based on the presence of the various RDC/TMD axis I diagnostic groups. The two main psychological parameters assessed in axis II were depression and somatization. The both psychological parameters were measured with the subscales of the Symptom Checklist-90 (SCL-90). Differences in mean Symptom Checklist-90 scores between groups were compared by analysis of variance/Scheffé tests to contrast depression and somatization levels between the various axis I diagnostic groups (P = 0.05). The frequencies of the different groups were as follows: group A, 35.7% ; group B, 18.2% ; group C, 7.8% ; group D, 9.1% ; group E, 13.0% ; group F, 9.1% ; group G, 7.1%. Approximately 55% of patients were clinically depressed, and 65% had moderate to severe somatization. Differences in means depression and somatization with pain item scores were significant between groups (P < 0.05). Patients diagnosed with myofascial pain and other joint conditions (group E) had significantly higher levels of depression (P = 0.014) and somatization (P = 0.032) than patients diagnosed with only disk displacements (group B). Psychological factors are generally recognized as important variables in the diagnosis of orofacial pain.

Psychological status; temporomandibular disorders

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