J Oral Facial Pain Headache. 2018 Summer;32(3):309–320. doi: 10.11607/ofph.1968. Epub 2018 Apr 25.
To describe pain catastrophizing in temporomandibular disorder (TMD) patients in relation to disability and pain persistence.
A total of 163 TMD patients underwent a complete TMD evaluation according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), including the Pain Catastrophizing Scale (PCS). Patients were divided into subgroups according to their PCS, Graded Chronic Pain Scale (GCPS), and pain persistence scores. The GCPS and pain persistence subgroups were assigned as dependent variables in a stepwise multiple logistic regression model. The ability of the DC/TMD Axis II parameters and of the PCS to discriminate between patients of low and high disability (according to the GCPS) and low and high pain persistence were examined using area under the receiver operating characteristic (ROC) curve. α < .05 was considered to reflect statistical significance.
Significant differences were found between high and low pain catastrophizing patients as to socioeconomic parameter, Axis I diagnoses, pain persistence, and Axis II evaluation. The parameters with significant discriminant ability for pain persistence were pain catastrophizing, depression, and nonspecific physical symptoms, with no significant differences between them. Depression increased the odds of high disability by 1.2, while pain catastrophizing increased the odds for high pain persistence more than 6-fold. Pain catastrophizing was not significantly associated with pain disability, and depression was not significantly associated with pain persistence.
High-pain catastrophizing TMD patients were similar to patients with other chronic pain conditions, but differed from TMD patients as a group. The findings of this study support the addition of an assessment for pain catastrophizing to the DC/TMD for early identification of TMD patients who might be at higher risk for developing chronic pain.
描述颞下颌关节紊乱病（TMD）患者的疼痛灾难化与残疾和疼痛持续存在的关系。
共有 163 名 TMD 患者根据颞下颌关节紊乱病诊断标准（DC/TMD）接受了全面的 TMD 评估，包括疼痛灾难化量表（PCS）。根据 PCS、慢性疼痛分级量表（GCPS）和疼痛持续时间评分，将患者分为亚组。GCPS 和疼痛持续时间亚组被分配为逐步多元逻辑回归模型的因变量。使用接受者操作特征（ROC）曲线下的面积来检查 DC/TMD 轴 II 参数和 PCS 区分低和高残疾（根据 GCPS）以及低和高疼痛持续时间患者的能力。α<0.05 被认为具有统计学意义。
高和低疼痛灾难化患者在社会经济参数、轴 I 诊断、疼痛持续时间和轴 II 评估方面存在显著差异。对疼痛持续时间具有显著判别能力的参数是疼痛灾难化、抑郁和非特异性躯体症状，它们之间没有显著差异。抑郁使高残疾的几率增加了 1.2 倍，而疼痛灾难化使高疼痛持续时间的几率增加了 6 倍以上。疼痛灾难化与疼痛残疾无显著相关性，抑郁与疼痛持续时间无显著相关性。
高疼痛灾难化的 TMD 患者与其他慢性疼痛疾病的患者相似，但与 TMD 患者群体不同。本研究的结果支持在 DC/TMD 中增加疼痛灾难化评估，以早期识别可能患有慢性疼痛风险较高的 TMD 患者。
