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颞下颌关节紊乱病患者的躯体共病与心理相关性。

Psychological correlates of medical comorbidities in patients with temporomandibular disorders.

机构信息

Psychology Department, College of Arts and Sciences, University of Kentucky, Lexington, KY 40506, USA.

出版信息

J Am Dent Assoc. 2010 Jan;141(1):22-31. doi: 10.14219/jada.archive.2010.0017.

DOI:10.14219/jada.archive.2010.0017
PMID:20045818
Abstract

BACKGROUND

Medical comorbidities are common among patients with temporomandibular disorders (TMDs). The authors examined the relationship between the medical comorbidities in patients with TMDs and their psychological functioning.

METHODS

The sample consisted of 1,060 adults with TMDs, of whom 85 percent (n = 901) were female. At the time patients were evaluated at a university orofacial pain center, from 1997 through 2007, they completed medical history and psychological questionnaires. On the basis of retrospective chart reviews, the authors assessed the relationship between medical comorbidities and psychological functioning, controlling for pain severity, by using multivariate analyses of covariance.

RESULTS

The mean total number of medical comorbidities was 3.49 (standard deviation [SD] = 2.87; range, 0-16). The authors found a linear relationship between number of medical comorbidities and overall psychological distress (t[1, 959] = 16.79, P < .001) and interference owing to pain (t[1, 1,028] = 18.03, P < .001).

CONCLUSIONS

Patients with TMDs who have medical comorbidities may be at increased risk of experiencing poor psychological functioning. Further study is needed to investigate whether the observed relationship changes across time.

CLINICAL IMPLICATIONS

The physical and psychological health of patients with TMDs may influence the course of their pain condition. When treating these patients, dentists routinely should assess not only the symptoms of their TMDs but also their general health status.

摘要

背景

颞下颌关节紊乱病(TMD)患者常伴有医学共病。作者研究了 TMD 患者的医学共病与其心理功能之间的关系。

方法

该样本包括 1060 名 TMD 成年患者,其中 85%(n=901)为女性。1997 年至 2007 年期间,患者在大学口腔颌面疼痛中心接受评估时,完成了病史和心理问卷。根据回顾性病历审查,作者通过协方差的多变量分析,控制疼痛严重程度,评估了医学共病与心理功能之间的关系。

结果

平均共病数量为 3.49(标准差[SD]=2.87;范围 0-16)。作者发现,共病数量与整体心理困扰(t[1,959]=16.79,P<.001)和疼痛所致干扰(t[1,1,028]=18.03,P<.001)之间存在线性关系。

结论

患有 TMD 并伴有医学共病的患者可能面临较差的心理功能的风险增加。需要进一步研究来探讨观察到的关系是否会随时间变化。

临床意义

TMD 患者的身心健康可能影响其疼痛状况的进程。在治疗这些患者时,牙医通常不仅应评估 TMD 的症状,还应评估其总体健康状况。

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