Psychosocial impairment in temporomandibular disorders patients. RDC/TMD axis II findings from a multicentre study

Manfredini, Daniele; Winocur, Ephraim; Ahlberg, Jari; Guarda-Nardini, Luca; Lobbezoo, Frank

doi:10.1016/j.jdent.2010.06.007

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Volume 38, Issue 10 , Pages 765-772, October 2010

Psychosocial impairment in temporomandibular disorders patients. RDC/TMD axis II findings from a multicentre study

Daniele Manfredini
- TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Italy
- Corresponding author at: TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Viale XX Settembre 298, 54033 Marina di Carrara (MS), Italy. Tel.: +39 0585 630964.
Ephraim Winocur
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dentistry, University of Tel Aviv, Israel
Jari Ahlberg
- Department of Stomatognathic Physiology and Prosthetic Dentistry, Institute of Dentistry, University of Helsinki, Finland
Luca Guarda-Nardini
- TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Italy
Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute MOVE, University of Amsterdam and VU University Amsterdam, The Netherlands

Received 13 April 2010; received in revised form 12 June 2010; accepted 19 June 2010. published online 28 June 2010.

Abstract

Objectives

The relationship between the rate of chronic pain-related disability and depression and somatization levels as well as the influence of pain duration on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis II findings were assessed in a three centre investigation.

Methods

The study sample (N=1149; F:M 4.1:1, m.a. 38.6 years) consisted of patients seeking for TMD treatment and undergoing RDC/TMD axis II psychosocial assessment to be rated in chronic pain-related disability (Graded Chronic Pain Scale, GCPS), depression (Symptoms Checklist-90[SCL-90] scale for depression, DEP) and somatization levels (SCL-90 scale for non-specific physical symptoms, SOM). The null hypotheses to be tested were that (1) no correlation existed between GCPS categories and DEP and SOM scores, and (2) no differences emerged between patients with pain from more or less than 6 months as for the prevalence of the different degrees of pain-related impairment, depression, and somatization.

Results

In the overall sample, the prevalence of high pain-related disability (GCPS grades III or IV), severe depression and somatization was 16.9%, 21.4%, and 28.5%, respectively. A correlation was shown between GCPS and both DEP and SOM categories (Spearman's correlation test, p<0.001). A significant association between pain lasting from more than 6 months and high GCPS scores was shown (χ², p<0.001), while no association was found between DEP and SOM scores and pain duration in the overall sample (χ², p=0.742 and p=0.364, respectively).

Conclusions

Pain-related disability was found to be strongly related with depression and somatization levels as well as associated with pain duration. Depression and somatization scores were not associated with pain duration.

Keywords: Temporomandibular disorders, Research Diagnostic Criteria for Temporomandibular Disorders, RDC/TMD, Psychosocial assessment, Multicentre study