Manfredini Daniele, di Poggio Adolfo Bandettini, Romagnoli Mario, Dell'Osso Liliana, Bosco Mario
Section of Prosthetic Dentistry, Department of Neuroscience, University of Pisa, Italy.
Cranio. 2004 Jul;22(3):234-40. doi: 10.1179/crn.2004.028.
The purpose of this study was to investigate for difference in the prevalence of mood disorders between patients with different painful temporomandibular disorders (TMD). After a sample size necessary for the study was calculated, 60 patients with a painful TMD were selected and divided into the following groups: myofascial pain (n=20), temporomandibular joint (TMJ) pain (n=18), combined myofascial and TMJ pain (n=22). Two distinct comparison groups were selected: subjects with a nonpainful TMD (n=25) and TMD-free subjects (n=29). All participants filled out a self-report validated instrument (MOODS-SR) to evaluate psychopathological symptoms related to mood disturbances. A one-way analysis of variance (ANOVA) with Bonferroni's post hoc test for multiple comparisons was performed to investigate for significant differences among the groups. The three groups of patients with painful TMD scored significantly higher than comparison groups in all MOODS-SR domains investigating depression, but no difference was shown between subjects with myofascial pain and those with TMJ pain. No significant differences among the groups emerged for the presence of manic symptoms, indicating that depressive disorders associated with TMD are not an expression of a more complex manic depressive illness. The study concluded that the presence of depressive symptoms in TMD patients seems to be related to the presence of a painful condition and seems to be unrelated to the location of pain. Furthermore, depressive disturbances in painful TMD patients affect the whole spectrum of depressive psychopathology.
本研究的目的是调查不同疼痛性颞下颌关节紊乱症(TMD)患者中情绪障碍患病率的差异。在计算出本研究所需的样本量后,选取了60例疼痛性TMD患者并分为以下几组:肌筋膜疼痛组(n = 20)、颞下颌关节(TMJ)疼痛组(n = 18)、肌筋膜和TMJ联合疼痛组(n = 22)。选取了两个不同的对照组:无痛性TMD受试者(n = 25)和无TMD受试者(n = 29)。所有参与者均填写了一份经过验证的自我报告工具(MOODS-SR),以评估与情绪障碍相关的精神病理症状。采用单因素方差分析(ANOVA)并结合Bonferroni事后检验进行多重比较,以研究各组之间的显著差异。在所有调查抑郁的MOODS-SR领域中,三组疼痛性TMD患者的得分均显著高于对照组,但肌筋膜疼痛患者与TMJ疼痛患者之间未显示出差异。各组之间在躁狂症状的存在方面未出现显著差异,这表明与TMD相关的抑郁障碍并非更复杂的双相情感障碍的表现。该研究得出结论,TMD患者中抑郁症状的存在似乎与疼痛状况的存在有关,而似乎与疼痛部位无关。此外,疼痛性TMD患者的抑郁障碍影响抑郁精神病理学的整个范围。