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不同疼痛部位的颞下颌关节紊乱病患者的精神病理学特征

Psychopathologic Profiles of TMD Patients with Different Pain Locations.

作者信息

Tournavitis Alexandros, Tortopidis Dimitrios, Fountoulakis Konstantinos, Menexes George, Koidis Petros

出版信息

Int J Prosthodont. 2017 May/Jun;30(3):251-257. doi: 10.11607/ijp.5155.

Abstract

PURPOSE

The aim of this study was to examine whether psychopathologic profile is related to the location of pain in temporomandibular disorder (TMD) patients with myofascial and/or temporomandibular joint pain.

MATERIALS AND METHODS

A total of 75 painful TMD patients (39 women and 36 men) participated in the study. Participants were divided into three groups (myogenous, arthrogenous, and mixed) using the Research Diagnostic Criteria for TMD (RDC/TMD) Axis I guidelines for assessment of TMD signs and symptoms. Three psychometric instruments were used to assess the psychopathologic profile of the TMD subgroups. Patients' state and trait anxiety were assessed using the State-Trait Anxiety Inventory (STAI-S, STAI-T), depression was measured with the Center for Epidemiological Studies Depression Scale (CES-D), and psychosocial functioning was evaluated using the Global Disability Scale (Glo.Di.S). The three TMD groups were compared with Kruskal-Wallis test followed by pairwise Mann-Whitney tests relative to the psychometric scores. Statistical analyses were performed with SPSS 15.0 software.

RESULTS

No significant differences were detected among the different TMD groups in the three psychometric scales; STAI-T, CES-D, Glo.Di.S (P > .05). When the psychometric scale of state anxiety (STAI-S) was considered, significant differences were revealed between the myogenous and the arthrogenous pain groups (P = .008) and also between the mixed and the arthrogenous groups (P < .001).

CONCLUSION

These findings suggest that the psychopathologic profile is not related to the location of pain in TMD patients. However, anxiety was found to be higher in TMD patients with myogenous pain alone or combined with arthrogenous pain compared to those with only arthrogenous pain.

摘要

目的

本研究旨在探讨心理病理特征是否与颞下颌关节紊乱病(TMD)伴肌筋膜和/或颞下颌关节疼痛患者的疼痛部位有关。

材料与方法

共有75例疼痛性TMD患者(39名女性和36名男性)参与本研究。根据颞下颌关节紊乱病研究诊断标准(RDC/TMD)第一轴指南对TMD体征和症状进行评估,将参与者分为三组(肌源性、关节源性和混合型)。使用三种心理测量工具评估TMD亚组的心理病理特征。采用状态-特质焦虑量表(STAI-S、STAI-T)评估患者的状态和特质焦虑,用流行病学研究中心抑郁量表(CES-D)测量抑郁程度,并用全球残疾量表(Glo.Di.S)评估社会心理功能。采用Kruskal-Wallis检验对三个TMD组的心理测量得分进行比较,随后进行两两Mann-Whitney检验。使用SPSS 15.0软件进行统计分析。

结果

在三种心理测量量表(STAI-T、CES-D、Glo.Di.S)中,不同TMD组之间未检测到显著差异(P > .05)。当考虑状态焦虑的心理测量量表(STAI-S)时,肌源性疼痛组和关节源性疼痛组之间存在显著差异(P = .008),混合型疼痛组和关节源性疼痛组之间也存在显著差异(P < .001)。

结论

这些结果表明,心理病理特征与TMD患者的疼痛部位无关。然而,发现单纯肌源性疼痛或合并关节源性疼痛的TMD患者比仅有关节源性疼痛的患者焦虑程度更高。

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