Psychological distress and diagnostic subgroups of temporomandibular disorder patients

Abstract

This study examined the nature and extent of psychological differences among diagnostic subgroups of temporomandibular disorder (TMD) patients. Three subgroups were identified and labeled as: (1) primary myalgia, (2) primary temporomandibular joint (TMJ) problems, or (3) combination myalgia and TMJ problems. Patients' (n = 112) levels of pain and distress were measured using a VAS pain scale, the McGill Pain Questionnaire, the Beck Depression Inventory, the State-Trait Anxiety Scale and the MMPI. Patients with primary myalgia had the highest scores on the pain and distress measures while patients in the combination group scored between the myalgia and TMJ problem subgroups. When differences in pain levels were controlled, the differences among groups on measures of anxiety and depression were attenuated while the differences on measures of somatic overconcern remained significant. Discriminant function analysis using psychological variables to predict diagnostic grouping produced correct identification of 74% of the structural patients and 46% of the myalgia patients. Implications for different etiological factors among the 3 groups are discussed.

Personality Traits and Subjective Health Complaints in Female TMD Patients and Healthy Controls

“…Research on psychological differences between subgroups of TMD patients has generated equivocal results. Some studies have found that the myalgic subgroup tend to report higher levels of psychological and somatic distress than the other subgroups, also when controlling for differences in pain level [20,56]. However, others [57] have not observed such differences.…”

Chronicity factors of temporomandibular disorders: a critical review of the literature

“…31 Myalgia patients may experience more stressful life circumstances and a greater negative effect of illness. 5 These patients showed more severe depressive and nonspecific physical symptoms than patients with internal derangement. 32 The myogenous pain subgroup had significantly higher somatization and depression scores than the normal and arthrogenous pain subgroups.…”

“…4 Psychological distress is believed to result from the discomfort and frustration associated with the disorder, and it has a bidirectional role in TMD pain. 5 Pain amplification refers to alterations in peripheral and central nervous system processes that have Declaration of Interests: The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript. the net effect of amplifying the perceptual response to nociceptive stimuli (e.g., hyperalgesia, allodynia).…”

Relationship between temporomandibular disorder symptoms signs and Burnout syndrome among dentistry students

“…TMD patients may also have stress-related disorders, characterized by somatic and psychological changes such as fatigue, sleep disorders, anxiety and depression 5,6 . So, previous studies have shown that TMD patients have higher levels of stress, depression and anxiety, as compared to healthy control groups, and that some TMD symptoms and orofacial pain may be just somatic manifestations of emotional stress [7][8][9][10] . Also, TMD patients seem to have high levels of plasma cortisol/creatinine and of 17-hydroxisteroid in the urine, showing a high level of anxiety 11 .…”