The effect of catastrophizing and depression on chronic pain – a prospective cohort study of temporomandibular muscle and joint pain disorders

Abstract

Although most cases of temporomandibular muscle and joint disorders (TMJD) are mild and self-limiting, about 10% of TMJD patients develop severe disorders associated with chronic pain and disability. It has been suggested that depression and catastrophizing contributes to TMJD chronicity. This article assesses the effects of catastrophizing and depression on clinically significant TMJD pain (Graded Chronic Pain Scale [GCPS] II-IV). Four hundred eighty participants, recruited from the Minneapolis/St. Paul area through media advertisements and local dentists, received examinations and completed the GCPS at baseline and at 18-month follow-up. In a multivariable analysis including gender, age, and worst pain intensity, baseline catastrophizing (β 3.79, P<0.0001) and pain intensity at baseline (β 0.39, P<0.0001) were positively associated with characteristic of pain intensity at the 18th month. Disability at the 18-month follow-up was positively related to catastrophizing (β 0.38, P<0.0001) and depression (β 0.17, P=0.02). In addition, in the multivariable analysis adjusted by the same covariates previously described, the onset of clinically significant pain (GCPS II-IV) at the 18-month follow-up was associated with catastrophizing (odds ratio [OR] 1.72, P=0.02). Progression of clinically significant pain was related to catastrophizing (OR 2.16, P<0.0001) and widespread pain at baseline (OR 1.78, P=0.048). Results indicate that catastrophizing and depression contribute to the progression of chronic TMJD pain and disability, and therefore should be considered as important factors when evaluating and developing treatment plans for patients with TMJD.

Are Psychological Factors Associated with Pain Worsening in Individuals with Knee Osteoarthritis? A Systematic Review

“…It has been reported that biopsychosocial variables such as catastrophizing play an important role in reported pain severity [38][39][40]. Studies in which functional magnetic resonance imaging was used showed that pain catastrophizing, independent of the influence of depression, was significantly associated with increased activity in brain areas related to anticipation of pain, attention to pain, and emotional aspects of pain [41].…”

Intervención psicológica en trastornos temporomandibulares: Revisión narrativa.

“…16 Es un factor cognitivo que involucra una exageración o magnificación de las sensaciones de dolor por las amenazas percibidas. 18 La TCC sumada a un tratamiento conservador ha demostrado disminución del dolor post tratamiento, y una disminución del catastrofismo. 17 Esta incluye técnicas de relajación, manejo del estrés y reestructuración cognitiva, resultando ser mejor que el tratamiento conservador.…”

Evaluation of depressive symptoms and quality of life in individuals with tinnitus and temporomandibular disorders

“…It is understood that the presence of depressive symptoms can contribute to the chronicity of TMD ( VELLY et al, 2011), mainly muscular, resulting indirectly in the plastic auditory changes that would be expressed by tinnitus, as a result of the interfering somatosensory impulses in the descending modulatory pathways (SALVINELLI et al, 2003). Even so, tinnitus is directly influenced by changes in the cortical networks and the neurotransmitter system, both compromised in depression cases (LANGGUTH et al, 2011), which results in considerable clinical comorbidity existing between tinnitus and depression.…”