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亚洲患者颞下颌关节紊乱症亚型、心理困扰及心理社会功能障碍的患病率

Prevalence of temporomandibular disorder subtypes, psychologic distress, and psychosocial dysfunction in Asian patients.

作者信息

Yap Adrian U J, Dworkin Samuel F, Chua E K, List Thomas, Tan Keson B C, Tan H H

机构信息

Department of Restorative Dentistry, Faculty of Dentistry, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Republic of Singapore.

出版信息

J Orofac Pain. 2003 Winter;17(1):21-8.

Abstract

AIMS

To use the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) to investigate the physical diagnoses, psychologic distress, and psychosocial dysfunction in Asian TMD patients. The RDC/TMD Axis I and II findings were compared to those of Swedish and American TMD patients.

METHODS

One hundred ninety-one patients (53 male and 138 female) referred to 2 institutionalized TMD clinics in Singapore were enrolled in the study. The mean age of the predominantly Chinese population (83.2%) was 33.6 +/- 9.3 years. Data from a RDC/TMD history questionnaire and clinical examination were fed directly by patients and clinicians into a computerized diagnostic system (NUS TMDv1.1). Axis I and II findings were generated on-line, based on RDC/TMD rule engines. Data were automatically exported to SPSS for statistical analysis.

RESULTS

Group I (muscle) disorders were found in 31.4% of the patients; Group II (disc displacement) disorders were found in 15.1% and 15.7% of the patients in the left and right temporomandibular joints, respectively; and Group III (arthralgia, arthritis, and arthrosis) disorders were found in 12.6% and 13.0% of the patients in the left and right joints, respectively. Axis II assessment of psychologic status showed that 39.8% of patients experienced moderate to severe depression and 47.6% had moderate to severe nonspecific physical symptom scores. Psychosocial dysfunction was observed in only 4.2% of patients based on graded chronic pain scores.

CONCLUSION

Axis I and II findings of Asian TMD patients were generally similar to their Swedish and American cohorts. In all 3 populations, women of child-bearing age represented the majority of patients. Muscle disorders were the most prevalent type of TMD. A substantial portion of TMD patients were depressed and experienced moderate to severe somatization.

摘要

目的

运用颞下颌关节紊乱病研究诊断标准(RDC/TMD)调查亚洲颞下颌关节紊乱病(TMD)患者的体格诊断、心理困扰及心理社会功能障碍情况。将RDC/TMD第一轴和第二轴的研究结果与瑞典和美国TMD患者的结果进行比较。

方法

191例患者(53例男性和138例女性)被纳入该研究,这些患者均被转诊至新加坡两家设有专门门诊的TMD诊所。以华裔为主(83.2%)的研究对象平均年龄为33.6±9.3岁。患者和临床医生将RDC/TMD病史问卷及临床检查数据直接录入计算机诊断系统(新加坡国立大学TMDv1.1)。基于RDC/TMD规则引擎在线生成第一轴和第二轴的研究结果。数据自动导出至SPSS进行统计分析。

结果

31.4%的患者被诊断为第I组(肌肉)紊乱;左侧和右侧颞下颌关节分别有15.1%和15.7%的患者被诊断为第II组(盘移位)紊乱;左侧和右侧关节分别有12.6%和13.0%的患者被诊断为第III组(关节痛、关节炎和关节病)紊乱。心理状态的第二轴评估显示,39.8%的患者有中度至重度抑郁,47.6%的患者有中度至重度非特异性躯体症状评分。基于分级慢性疼痛评分,仅4.2%的患者存在心理社会功能障碍。

结论

亚洲TMD患者第一轴和第二轴的研究结果总体上与其瑞典和美国的队列相似。在这三个群体中,育龄女性均占患者大多数。肌肉紊乱是TMD最常见的类型。相当一部分TMD患者存在抑郁并伴有中度至重度躯体化症状。

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