Association of temporomandibular disorder symptoms with anxiety and depression in Portuguese college students

Abstract

Abstract:We investigated the prevalence of temporomandibular disorder (TMD) and its association with anxiety and depression among 1,493 Portuguese college students (age 17-69 years) at Piaget Institute. The assessment instruments were the Fonseca Anamnestic Questionnaire and the Hospital Anxiety and Depression Scale. TMD was present in 633 (42.4%) students, and anxiety or depression was present in 456 (30.5%) students. Regarding the association of TMD with anxiety and depression, 280 of the 633 students (61.4%) with TMD symptoms also had signs of anxiety or depression (P < 0.001). As compared with men, women had an odds ratio of 1.9 (95% confidence interval: 1.53-2.46; P < 0.001) for TMD. As compared with students without signs of anxiety or depression, students with such signs had an odds ratio of 3.1 (95% confidence interval: 2.42-3.84; P < 0.001) for TMD. College students from various fields of study and regions of Portugal had a high prevalence of TMD, which was significantly associated with anxiety and depression. (J Oral Sci 56, 127-133, 2014)

Prevalência de sinais e sintomas de disfunção temporomandibular em estudantes pré-vestibulandos: associação de fatores emocionais, hábitos parafuncionais e impacto na qualidade de vida

“…In this study, the report of emotional stress was statistically associated with the presence of TMD symptoms and the need for treatment (DMF index). These findings were consistent with other studies performed in various populations 17,28 . It is believed that stress can affect biological processes related to the transmission and perception of pain, promoting chronic muscular hyperactivity, which in turn can damage the TMJ and related structures, in addition to contributing to the creation and evolution of parafunctional habits 8,50 .…”

“…It is believed that stress can affect biological processes related to the transmission and perception of pain, promoting chronic muscular hyperactivity, which in turn can damage the TMJ and related structures, in addition to contributing to the creation and evolution of parafunctional habits 8,50 . Several studies have also shown a significant correlation between anxiety and depression and the presence of signs and symptoms of TMD 11,12,15,28,29 . Corroborating these results, data showed that anxiety was statistically associated with the presence of TMD signs and symptoms (DMF index or simplified clinical examination) and the need for treatment (DMF index).…”

“…In the present study, female gender was strongly associated with the presence of symptoms and clinical signs of TMD (DMF index and simplified clinical examination), as with "treatment need" (DMF index). A higher prevalence of TMD in females has been widely reported in the literature 2,4,5,28,45 , but the reasons for this prevalence remain controversial. Factors such as increased sensitivity to pain, the increased prevalence of emotional stress, anxiety, or depression, physiological differences (hormonal differences), differences in muscular structure, and increased preoccupation and treatment seeking 1,9,41 in females have all been proposed.…”

“…The prevalence of the signs and symptoms of TMD in adolescents varies widely due to individual differences, sample variability (heterogeneous age groups, sample size, and selection criteria), and different evaluation methods 27,45 . Thus, epidemiological studies in children have found a TMD prevalence between 21-74% 4,16,28 . In this study, the age range varied between 15-25 years of age, including adolescents and young adults.…”

“…In addition, the college entrance exam, which is considered to be a competitive and stressful system for acceptance to Brazilian universities, may be reflected by increased social and familial pressure, anxiety, stress, and other emotional disorders closely related to a diagnosis of TMD 25,26 . In addition, several studies have investigated the prevalence of TMD and associated factors in children 3,7,14,27 , adolescents 2,4,16 , college students 9,15,18,23,28 , adults 10,12,21,29 and elderly 30 , however few information is available about college preparatory students, subjected to high psychosocial burden, including psychological and physical manifestations of stress and anxiety 24,26,31,32 . Thus, the aim of this study is to evaluate the presence of signs and symptoms of TMD, its correlation with gender, reports of parafunctional habits, emotional stress, anxiety, and depression and its effects on OHRQL in college preparatory students enrolled in their last year of high school or college entrance exam courses in João Pessoa, Paraíba (PB).…”