Mongini F, Ciccone G, Ibertis F, Negro C
Unit for Headache and Facial Pain, Department of Clinical Pathophysiology, University of Turin, Corso Dogliotti 14, I. 10126 Turin, Italy.
J Orofac Pain. 2000 Winter;14(1):52-8.
Patients with different facial pain/headache pathologies usually complain of numerous accompanying symptoms relative to systemic dysfunctions or to the patient's personality characteristics. The purpose of this work was: (1) to determine the prevalence of accompanying symptoms in groups of patients with temporomandibular joint (TMJ) dysfunction and other types of facial pain or headache disorders, (2) to assess the patients' personality characteristics and anxiety levels, and (3) to see whether significant differences were found between the groups.
Two hundred forty-three patients were considered. They had TMJ intracapsular disorder (TMJ, n = 71), tension-type headache (TH, n = 52), migraine (M, n = 68), chronic daily headache (CDH, n = 26), or facial pain disorder as somatoform disorder (FP, n = 26). The presence of 23 symptoms was assessed; the Minnesota Multiphasic Personality Inventory (MMPI) and the Spielberger State and Trait Anxiety Inventory (STAI) were administered and the relative scores were calculated. Four different MMPI clusters (depressive, conversive, emotional, coper) were also considered. Intergroup differences were assessed by Chi-square analysis, 1-way analysis of variance, Bonferroni t test, and a logistic regression model and then standardized for gender and age, taking the tension-type headache group as a common reference group.
The TMJ group had: (1) a lower prevalence of almost all symptoms; (2) significantly lower scores of several MMPI and of state anxiety; and (3) odds ratio values < 1 for all symptoms except phobias and for emotional, conversive, and depressive MMPI profiles. The FP and CDH groups had the highest prevalence of the majority of symptoms and higher MMPI and STAI scale elevations.
It is concluded that some types of headache and facial pain seem to correlate with the presence of a number of accompanying symptoms and with some changes in personality. These changes are particularly relevant in patients with chronic daily headache and facial pain disorder. In contrast, patients with TMJ intracapsular disorders tended to show a low prevalence of accompanying symptoms and a normal personality profile.
患有不同面部疼痛/头痛病症的患者通常会抱怨有许多与全身功能障碍或患者个性特征相关的伴随症状。这项研究的目的是:(1)确定颞下颌关节(TMJ)功能障碍患者组以及其他类型面部疼痛或头痛病症患者组中伴随症状的患病率;(2)评估患者的个性特征和焦虑水平;(3)观察各组之间是否存在显著差异。
共纳入243例患者。他们患有颞下颌关节囊内疾病(TMJ,n = 71)、紧张型头痛(TH,n = 52)、偏头痛(M,n = 68)、慢性每日头痛(CDH,n = 26)或作为躯体形式障碍的面部疼痛障碍(FP,n = 26)。评估了23种症状的存在情况;使用明尼苏达多相人格调查表(MMPI)和斯皮尔伯格状态-特质焦虑量表(STAI)进行评估并计算相关得分。还考虑了四个不同的MMPI聚类(抑郁、转换、情绪、应对)。通过卡方分析、单因素方差分析、Bonferroni t检验和逻辑回归模型评估组间差异,然后以紧张型头痛组作为共同参照组,对性别和年龄进行标准化。
颞下颌关节组有:(1)几乎所有症状的患病率较低;(2)几种MMPI得分和状态焦虑得分显著较低;(3)除恐惧症以及情绪、转换和抑郁MMPI剖面图外,所有症状的比值比均<1。面部疼痛障碍组和慢性每日头痛组大多数症状的患病率最高,MMPI和STAI量表升高幅度更大。
得出的结论是,某些类型的头痛和面部疼痛似乎与多种伴随症状的存在以及个性的一些变化相关。这些变化在慢性每日头痛和面部疼痛障碍患者中尤为明显。相比之下,患有颞下颌关节囊内疾病的患者伴随症状的患病率往往较低,个性特征正常。