Abstract
BackgroundThe aims of this study were to examine whether patients’ psychosocial profiles influence the location of pain, and to identify the clinical and psychosocial predictors of high levels of pain-related disability in temporomandibular disorders (TMD) patients with chronic pain at least 6 months in duration.MethodsThe Research Diagnostic Criteria of TMD (RDC/TMD) data for Axis I and II were obtained for 104 consecutive patients seeking treatment.Data were analyzed using descriptive statistics, t-test, Mann–Whitney U-test, chi-square test, One-way ANOVA, Kruskal-Wallis test, and binary multiple logistic regression tests. Patients were classified into two groups according to Graded Chronic Pain Scale scores: Grade III and IV were scored for patients with high levels of pain-related disability, whereas Grade I and II were scored for patients with low disability.ResultsMuscle and joint pain were found in 64.9% and 31.8% of the patients, respectively, and 27.3% of the patients suffered from both muscle and joint pain.Psychosocial disability was found in 26% of patients. There were no statistically significant differences among the diagnostic subgroups with regards to the demographic, behavioral, psychological, and psychosocial characteristics. Patients with high levels of pain-related disability had significantly higher depression, somatization, pain intensity and jaw disability scores than those with low levels of pain-related disability.Patients with high levels of pain-related disability were more likely to have higher pain intensity, to report higher somatization symptoms and functional impairment, and were less likely to have joint pain than those with low levels of pain related disability.ConclusionIn conclusion, the Turkish version RDC/TMD, based on a dual axis system, may be used to screen chronic TMD patients at high-risk for pain-related disability who need comprehensive care treatment program.
Highlights
The aims of this study were to examine whether patients’ psychosocial profiles influence the location of pain, and to identify the clinical and psychosocial predictors of high levels of pain-related disability in temporomandibular disorders (TMD) patients with chronic pain at least 6 months in duration
This study showed that the estimated prevalence of psychosocial dysfunction in Turkish patients with chronic TMD pain was higher than that reported in the previous studies on TMD patients [4,18,19,21,22,25,26,37,38]
We found that Characteristic Pain Intensity (CPI) was a highly significant predictor of high disability in patients with chronic TMD while previous studies using the “high-risk versus low-risk” model for the development of chronic TMD showed that patients with high risk reported more pain on the CPI relatively, than the patients with low risk [15,16,17]
Summary
The aims of this study were to examine whether patients’ psychosocial profiles influence the location of pain, and to identify the clinical and psychosocial predictors of high levels of pain-related disability in temporomandibular disorders (TMD) patients with chronic pain at least 6 months in duration. Recent studies have reported that psychological conditions (i.e. depression and catastrophizing) contribute to the progression of chronic TMD pain and disability [32] and that psychosocial variables (i.e., psychosocial symptoms, affective distress, somatic awareness, and pain catastrophizing) may be premorbid risk factors for the development of chronic TMD pain [33]
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