Identification of psychological comorbidity in TMD-patients

Abstract

A regular screening for psychological problems, using standardized questionnaires, should be integrated in clinical examination of TMD patients.

WHO-5 well-being index as screening instrument for psychological comorbidity in patients with temporomandibular disorder

“…Some literature point out the notion that psychological comorbidity is a predictor of chronicity on TMD patients, but also the presence of psychological problems has been found to be a risk factor of future TMD [4]. A longitudinal study is necessary to conclude the predictors of the OHRQoL.…”

“…On the basis of the RDC/TDM criteria, the TMD patients were grouped according to their diagnosis: 30.4% of these were diagnosed with myopathy, 6.5% with disc displacement without reduction, 21.7% with disc displacement with reduction, 10.9% with arthrosis, 9.8% with a combination of disc displacement without reduction and additional arthrosis, 18.5% with a combination of comorbidity because a high proportion of TMD patients simultaneously show psychological disorders [4]. The WHO-5 Index is a short and economic instrument (five items) to assess emotional well-being and to evaluate the psychological health of patients with chronic diseases [15].…”

“…TMD patients often report stressful life events and high levels of anxiety [8,9]. It is also well documented that the prevalence of depression is greater in TMD patients than in the general population [4].…”

“…Between 5 and 12% of the general population is affected by TMD [1], but only 3% are in need of specific functional treatment [2]. The etiology of TMD is considered to be multifactorial and may be induced by interaction between various factors, such as muscular or articular problems or by the patient's psychosocial burden or psychological disorder [3,4]. Occlusal interference is considered as a minimal factor for the development of TMD [5].…”

Management of temporomandibular joint disorders: A surgeon's perspective

“…Furthermore, underlying influences such as stress, anxiety, depression or significant life events must also be borne out during the consultation so that a clearer picture of a psychogenic basis to the temporomandibular disorder may be constructed . Generally speaking, the longer the duration of the symptoms, and the greater the number of treatments, in particular ‘failed treatments’, the less likely the patient will favourably respond to further treatment unless a psychogenic cause can be found …”