Psychometric features of temporomandibular disorders patients in relation to pain diffusion, location, intensity and duration.

The aim of the present investigation was to assess the psychological profile of a sample of patients with temporomandibular disorders (TMD) and to compare the psychometric scores between patients with pain of different diffusion, location, intensity and duration. One hundred and ten (N = 110) patients with painful TMD fulfilled three psychometric instruments. Pain features were assessed as categorical variables as concerns its diffusion, viz., diffuse or localised, duration, viz., more or <6 months, and location, viz., joint and/or muscles. Pain intensity was scored on a 0-100 Visual Analog Scale (VAS) rating. Patients with diffuse pain showed higher psychometric scores than patients with localised pain. No significant differences were detected between patients with pain lasting from more or equal than 6 months and those with pain lasting from <6 months as well as between patients with pain localised in the jaw muscles, joints or both, even if a trend for lower scores for patients with joint pain alone was observed. Pain intensity was significantly related with anxiety (ANX), depression (DEP) and somatisation(SOM) scores. In conclusion, pain diffusion and intensity were strongly related with high levels of SOM, ANX and DEP, while no differences in psychometric scores were detected between patients with pain of different duration and location.

[1]  Lr Derogatis,et al.  SCL-90-R, Administration, Scoring, and Procedures Manual-II for the R(evised) Version and Other Instruments of the Psychopathology Rating Scale Series , 1983 .

[2]  D. Manfredini,et al.  Psychosocial profiles of painful TMD patients. , 2009, Journal of oral rehabilitation.

[3]  J. Turner,et al.  Catastrophizing is associated with clinical examination findings, activity interference, and health care use among patients with temporomandibular disorders. , 2005, Journal of orofacial pain.

[4]  S. Dworkin,et al.  Comparing TMD diagnoses and clinical findings at Swedish and US TMD centers using research diagnostic criteria for temporomandibular disorders. , 1996, Journal of orofacial pain.

[5]  S. Dworkin,et al.  Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. , 1992, Journal of craniomandibular disorders : facial & oral pain.

[6]  A. Hinz,et al.  Psychosocial profiles of diagnostic subgroups of temporomandibular disorder patients. , 2008, European journal of oral sciences.

[7]  R. Martina,et al.  Personality characteristics of temporomandibular disorder patients using M.M.P.I. , 1998, Cranio : the journal of craniomandibular practice.

[8]  G. Clark,et al.  Psychological distress and diagnostic subgroups of temporomandibular disorder patients , 1991, Pain.

[9]  F. Lobbezoo,et al.  Correlation of RDC/TMD axis I diagnoses and axis II pain-related disability. A multicenter study , 2011, Clinical Oral Investigations.

[10]  M. Hamilton.  The assessment of anxiety states by rating. , 1959, The British journal of medical psychology.

[11]  D. Miglioretti,et al.  Widespread pain as a risk factor for dysfunctional temporomandibular disorder pain , 2003, Pain.

[12]  C. Molin.  From bite to mind: TMD--a personal and literature review. , 1999, The International journal of prosthodontics.

[13]  S. Dworkin,et al.  A randomized clinical trial of a tailored comprehensive care treatment program for temporomandibular disorders. , 2002, Journal of orofacial pain.

[14]  R. Ohrbach,et al.  Reliability, validity, and clinical utility of the research diagnostic criteria for Temporomandibular Disorders Axis II Scales: depression, non-specific physical symptoms, and graded chronic pain. , 2002, Journal of orofacial pain.

[15]  H. H. Tan,et al.  Depression and somatization in patients with temporomandibular disorders. , 2002, The Journal of prosthetic dentistry.

[16]  R. Ohrbach,et al.  The Research Diagnostic Criteria for Temporomandibular Disorders. IV: evaluation of psychometric properties of the Axis II measures. , 2010, Journal of orofacial pain.

[17]  K. Raphael,et al.  Widespread pain and the effectiveness of oral splints in myofascial face pain. , 2001, Journal of the American Dental Association.

[18]  R. Gatchel,et al.  Major psychological disorders in acute and chronic TMD: an initial examination. , 1996, Journal of the American Dental Association.

[19]  S. Dworkin,et al.  Multiple pains and psychosocial functioning/psychologic distress in TMD patients. , 2002, The International journal of prosthodontics.

[20]  A. Yap,et al.  Clinical TMD, pain-related disability and psychological status of TMD patients. , 2002, Journal of oral rehabilitation.

[21]  S. Dworkin,et al.  First onset of common pain symptoms: a prospective study of depression as a risk factor , 1993, Pain.

[22]  D. Turk,et al.  Psychological factors in chronic pain: evolution and revolution. , 2002, Journal of consulting and clinical psychology.

[23]  C. Greene.  The Etiology of Temporomandibular Disorders : Implications for Treatment , 2001 .

[24]  D. Manfredini,et al.  Mood and anxiety psychopathology and temporomandibular disorder: a spectrum approach. , 2004, Journal of oral rehabilitation.

[25]  F. Lobbezoo,et al.  Psychosocial impairment in temporomandibular disorders patients. RDC/TMD axis II findings from a multicentre study. , 2010, Journal of dentistry.

[26]  Wenjun Kang,et al.  Diagnostic Criteria for Temporomandibular Disorders . V : Methods Used to Establish and Validate Revised Axis I Diagnostic Algorithms , 2010 .

[27]  M. Hamilton.  A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[28]  J. Okeson.  The classification of orofacial pains. , 2008, Oral and maxillofacial surgery clinics of North America.

[29]  D. Manfredini,et al.  Mood Spectrum in Patients with Different Painful Temporomandibular Disorders , 2004, Cranio : the journal of craniomandibular practice.

[30]  P. Crawford,et al.  Diagnoses based on the Research Diagnostic Criteria for Temporomandibular Disorders in a biracial population of young women. , 2005, Journal of orofacial pain.