Field-testing a psychosocial assessment scoring form for TMD patients - summarizing axis II instruments

Abstract

Background The etiology of temporomandibular disorders (TMD) can be explained on the basis of a biopsychosocial model. However, psychosocial assessment is challenging in daily dental practice. The purpose of the current study was to field-test the practicability of a novel psychosocial assessment scoring form regarding the reliability of scoring procedures and the opinion of examiners. The working hypotheses were that the scoring results of inexperienced undergraduate students were similar to the results collected by a gold standard and that the scoring form was easy to use. Methods A psychosocial assessment scoring form was developed in accordance with guidelines of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), including results of the Graded Chronic Pain Scale (GCPS), Patient Health Questionnaires (PHQ), and Generalized Anxiety Disorders (GAD). Inexperienced operators (undergraduate students) examined patients with TMD-associated complaints and rated the practicability of the scoring form. The scoring results were recalculated by two experienced operators and a consensus was defined as a gold standard. Reliability coefficients were determined comparing results of the gold standard and the inexperienced operators. Results Sixty-five examiners used the scoring form to obtain results for patients with TMD-associated complaints. Of the patients, 78.8% received a diagnosis according to DC/TMD decision trees. Two-thirds of the operators (62.9%) stated that the form was easy to complete, and 83.0% would use it in their dental practice. The reliability coefficients ranged between 0.81–1.00. Conclusions Within the limitations of the present study, the psychosocial assessment scoring form seems to be an easy-to-use and practicable tool. The vast majority of the inexperienced examiners recommended the application.

Accuracy of temporomandibular disorders diagnosis evaluated through the diagnostic criteria for temporomandibular disorder (DC/TDM) Axis II compared to the Axis I evaluations: a systematic review and meta-analysis

“…Axis I and II evaluations provide a thorough assessment of the patient’s physical symptoms and psychosocial factors. Implementing DC/TMD can aid in accurately diagnosing and treating TMD, leading to improved patient outcomes [ 47 ].…”

Relationships between personality factors and DC/TMD Axis II scores of psychosocial impairment among patients with pain related Temporomandibular Joint Disorders

“…6,34 The tools in the DC/TMD Axis II protocol (including GCPS, PHQ-4, and GAD-7 tests) were used in this study to assess psychosocial impairment and disability among patients with pain due to temporomandibular disorders because they are considered valid and the current standard in this regard. 6, [34][35][36] In addition, the GCPS test is considered a valid and consistent tool to assess and categorize patients' TMD pain intensity and pain-related disability and interference with activities. 25 Besides, the PHQ-4 is a valid tool for identifying anxiety and depression including among TMD patients.…”

Exploring the Relationship between Perfectionism and Pain in Patients with Temporomandibular Disorders: A Cross-Sectional Study

“…Therefore, future prospective and longitudinal research designs are required to establish causality. Despite the satisfactory reliability and validity of PHQ-4 scale for the assessment of anxiety and depression in TMD patients [ 37 ], PHQ-4 scale is a comparatively simple measurement with relatively limited items and aspects about the psychological status and personality of individuals. Additionally, there was a lack of healthy controls included for comparison; therefore, whether perfectionism in TMD patients or NPT patients is higher than that in TMD-free individuals is unknown.…”