Meldolesi G, Picardi A, Accivile E, Toraldo di Francia R, Biondi M
Department of Psychiatric Sciences and Psychological Medicine, 3rd Chair of Psychiatry, 'La Sapienza' University of Rome, Rome, Italy.
Psychother Psychosom. 2000 Nov-Dec;69(6):322-8. doi: 10.1159/000012415.
Our aim was to deepen the understanding of the psychosomatic aspects of temporomandibular joint (TMJ) pain dysfunction syndrome. Patients affected by this syndrome were compared with both healthy subjects and psychiatric patients, using both self-report and physician-scored psychological measures.
Three sex- and age-matched groups were recruited: a TMJ group (n = 32), a healthy group (n = 22) and a psychiatric group (n = 22). The psychiatric group consisted of outpatients diagnosed as having a DSM-IV anxiety or depressive disorder of mild to moderate severity. Psychometric assessment included the Minnesota Multiphasic Personality Inventory (MMPI) and the Hamilton Anxiety Rating Scale (HARS).
Psychiatric patients scored higher than both the comparison groups on all but one of the MMPI scales; the majority of the differences were significant or approached significance. TMJ patients scored higher than healthy controls on the Hs (hypochondriasis; p< or =0.01), Hy (hysteria; p< or =0.01) and D (depression; p< or =0.05) scales. Psychiatric patients scored higher than TMJ patients on the HARS psychic anxiety subscale (p< or =0.05), while TMJ patients scored higher than psychiatric patients on the somatic anxiety subscale (p< or = 0.05).
Certain personality characteristics were associated with TMJ dysfunction. However, further longitudinal studies should be performed to properly assess causal relationships. Despite signs of neuroticism, anxiety and depression, patients with TMJ dysfunction differed from anxious and depressed patients. While the latter displayed a higher level of psychopathology, each group was characterised by a distinct pattern of anxiety symptoms. In addition, a substantial proportion of TMJ patients had little awareness of their inner states and emotions.
我们的目的是加深对颞下颌关节（TMJ）疼痛功能障碍综合征身心方面的理解。使用自我报告和医生评分的心理测量方法，将受该综合征影响的患者与健康受试者和精神科患者进行比较。
招募了三个性别和年龄匹配的组：一个TMJ组（n = 32）、一个健康组（n = 22）和一个精神科组（n = 22）。精神科组由被诊断患有轻度至中度严重程度的DSM-IV焦虑或抑郁障碍的门诊患者组成。心理测量评估包括明尼苏达多相人格调查表（MMPI）和汉密尔顿焦虑评定量表（HARS）。
除了一个MMPI量表外，精神科患者在所有其他量表上的得分均高于两个比较组；大多数差异具有显著性或接近显著性。TMJ患者在Hs（疑病；p≤0.01）、Hy（癔症；p≤0.01）和D（抑郁；p≤0.05）量表上的得分高于健康对照组。精神科患者在HARS精神焦虑子量表上的得分高于TMJ患者（p≤0.05），而TMJ患者在躯体焦虑子量表上的得分高于精神科患者（p≤0.05）。
某些人格特征与TMJ功能障碍有关。然而，应进行进一步的纵向研究以正确评估因果关系。尽管有神经质、焦虑和抑郁的迹象，但TMJ功能障碍患者与焦虑和抑郁患者不同。虽然后者表现出更高水平的精神病理学，但每组都有独特的焦虑症状模式。此外，相当一部分TMJ患者对其内心状态和情绪几乎没有意识。
