Influence of psychological factors on the prognosis of temporomandibular disorders pain

Abstract

Background/purpose The leading symptom of temporomandibular disorders (TMD) is pain, and psychological factors are involved in the persistence of TMD-related pain. Therefore, this study was aimed to analyze the influence of psychological factors on the prognosis of TMD-related pain. Materials and methods The medical records of 486 patients with TMD-related pain were analyzed. Each patient's psychological profile was assessed using the Symptom Checklist-90-Revised (SCL-90-R). Patients were classified into two groups according to a post-treatment numeric rating scale (NRS). Patients with an NRS score of 0 or 1 at the last visit were classified into group G, and those with an NRS score of 2 or greater were classified into group P. Following this, all patients were re-classified into groups N and R according to pain recurrence. Statistical analysis was performed to evaluate differences in the SCL-90-R T scores between the groups. In addition, multiple logistic regression analysis was used to identify psychological factors that affected treatment outcome. Results The patients in groups P and R had higher scores in all subscales of the SCL-90-R than groups G and N, respectively. In particular, somatization (SOM) and psychoticism (PSY) scores showed significant differences between the groups in the treatment outcome. Conclusion A correlation is identified between psychological factors and treatment outcome in patients with TMD-related pain. In particular, patients with elevated SOM and PSY scores are more likely to develop refractory pain, and thus require additional interventions to control this risk.

Psychological and Behavioral Factors Involved in Temporomandibular Myalgia and Migraine: Common but Differentiated Profiles

“…Most of the somatization studies used the SCL 90-R test [ 48 ] to measure somatization; since the BSI-18 is a brief validated version of it [ 35 ], the results can be compared. In line with our results, several authors also found that patients with myofascial pain or painful TMD showed a higher degree of somatization [ 41 , 43 , 49 ]. Finally, the OPPERA study [ 19 ] concluded that the somatic symptoms increase the risk of suffering from TMD and are one of the most important psychological predictors.…”

“…Likewise, in the present study, no significant differences were found in anxiety symptoms (BSI-18) in TMD myalgia patients in comparison to controls. In this case, previous experiments using similar measurements, such as SCL-90, also showed varied results [ 7 , 20 , 41 , 42 , 43 ]. This variety of results might be similarly explained by the TMD severity and type, the sample characteristics, and/or possible comorbidities.…”

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“…Its greater magnitude among professionals in the regions which at the time of data collection experienced a collapse of the health system, and cemeteries with a demand for burials which exceeded the operational capacity of these spaces, can be explained by the daily experience of deaths in alarming numbers. Feelings of impotence, insecurity regarding the provision of adequate personal protective equipment, the lack of a sense of normality and work overload due to the unrestrained advance of the pandemic, are all elements associated with an increase in negative and hostile symptoms [ 27 , 28 , 29 ].…”

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