Manfredini D, Marini M, Pavan C, Pavan L, Guarda-Nardini L
University of Padova, Italy.
J Oral Rehabil. 2009 Mar;36(3):193-8. doi: 10.1111/j.1365-2842.2008.01926.x.
The aim of the present investigation is to test the null hypothesis that the presence of psychopathology in patients with temporomandibular disorders (TMD) is related to the presence of pain, independent of its location [(i.e. myofascial and/or temporomandibular joint (TMJ) pain]. Ninety-six (n = 96) patients affected by painful TMD underwent a clinical assessment in accordance with the research diagnostic criteria for TMD (RDC/TMD) guidelines and filled out the Symptoms Check List - Revised (SCL-90-R) instrument to investigate the presence of symptoms of psychopathology. Patients with myofascial pain, alone or combined with TMJ pain, endorsed the highest scores in all SCL-90-R scales and showed the highest percentage of abnormal values in the depression (DEP) and somatization (SOM) scales for the assessment of depressive and somatization symptoms. Nonetheless, anova revealed no significant differences between groups in any of the SCL-90-R scales, except than in the Positive Symptom Total Index (F = 3.463; P = 0.035), and the chi-squared test did not detect any significant differences between groups for the prevalence of abnormal scores in the DEP and SOM scales. The existence of a close association between pain and psychosocial disorders in TMD patients was supported by the present study. The null hypothesis is that no differences exist between patients with different painful TMD cannot be fully accepted for the presence of psychosocial disorders because of the trend evidencing higher SCL-90-R scores for myofascial pain patients, alone or combined with TMJ pain, with respect to TMJ pain alone.
本研究的目的是检验零假设,即颞下颌关节紊乱症(TMD)患者的精神病理学表现与疼痛的存在有关,而与疼痛部位无关[即肌筋膜和/或颞下颌关节(TMJ)疼痛]。96名患有疼痛性TMD的患者按照TMD研究诊断标准(RDC/TMD)指南进行了临床评估,并填写了症状自评量表修订版(SCL-90-R)以调查精神病理学症状的存在情况。单独患有肌筋膜疼痛或合并TMJ疼痛的患者在所有SCL-90-R量表上的得分最高,并且在评估抑郁和躯体化症状的抑郁(DEP)和躯体化(SOM)量表中异常值的百分比最高。尽管如此,方差分析显示,除了阳性症状总分指数外(F = 3.463;P = 0.035),各SCL-90-R量表组间无显著差异,并且卡方检验未检测到DEP和SOM量表中异常得分患病率的组间显著差异。本研究支持TMD患者疼痛与心理社会障碍之间存在密切关联这一观点。零假设是不同疼痛性TMD患者之间不存在差异,但由于有证据表明单独患有肌筋膜疼痛或合并TMJ疼痛的患者相对于仅患有TMJ疼痛的患者,其SCL-90-R得分更高,因此不能完全接受该零假设,因为存在心理社会障碍。