Häggman-Henrikson Birgitta, M Visscher Corine, Wänman Anders, Ljótsson Brjánn, C Peck Christopher, Lövgren Anna
Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.
Department of Odontology/Clinical Oral Physiology, Umeå University, Umeå, Sweden.
J Oral Rehabil. 2021 Nov;48(11):1193-1200. doi: 10.1111/joor.13251. Epub 2021 Sep 15.
Temporomandibular disorders (TMD) are often associated with psychological comorbidities. One such comorbidity is pain catastrophising, that is, exaggeration of negative consequences of a painful event. The aim was to investigate catastrophising in individuals with painful TMD compared to controls and the association between catastrophising and pain intensity, number of pain sites and functional limitations.
A community-based sample of 110 individuals (83 women; 20-69 yrs) with painful TMDs (myalgia/arthralgia as per Diagnostic Criteria for TMD) and 190 age- and gender-matched controls (119 women; 20-69 yrs) from the Public Dental services in Västerbotten, Sweden, participated. Associations between catastrophising and functional jaw limitations, respectively, and painful TMD were evaluated with ordinal regression adjusted for the effect of gender and age. Associations (Spearman's correlation) of the Pain catastrophising Scale (PCS) with Jaw Functional Limitation Scale (JFLS-20), pain site number (whole-body pain map), and characteristic pain intensity (CPI) and intergroup comparisons (Mann-Whitney U test) of these variables were also calculated.
Levels of catastrophising were associated with TMD pain (OR 1.6, 95%CI 1.1-2.6). Among individuals with painful TMD, catastrophising was correlated to pain intensity (r=0.458, p<0.01) and functional limitations (r=0.294-0.321, p≤0.002), but not to number of pain sites.
Compared to controls, community-based individuals with painful TMD demonstrated higher levels of pain catastrophising, and this catastrophising was associated with increased pain intensity and jaw dysfunction. The relatively low scores of pain catastrophising suggest that even mild catastrophic thinking is associated with pain perception and jaw function, and should be considered in patient management.
颞下颌关节紊乱病（TMD）常伴有心理共病。其中一种共病是疼痛灾难化，即夸大疼痛事件的负面后果。本研究旨在调查疼痛性TMD患者与对照组相比的灾难化情况，以及灾难化与疼痛强度、疼痛部位数量和功能受限之间的关联。
从瑞典韦斯特博滕公共牙科服务机构选取了110名患有疼痛性TMD（根据TMD诊断标准为肌痛/关节痛）的个体（83名女性；年龄20 - 69岁）和190名年龄及性别匹配的对照组（119名女性；年龄20 - 69岁）作为社区样本参与研究。采用有序回归分析评估灾难化与功能性下颌受限以及疼痛性TMD之间的关联，并对性别和年龄的影响进行校正。还计算了疼痛灾难化量表（PCS）与下颌功能受限量表（JFLS - 20）、疼痛部位数量（全身疼痛图谱）、特征性疼痛强度（CPI）之间的关联（Spearman相关性），以及这些变量的组间比较（Mann - Whitney U检验）。
灾难化水平与TMD疼痛相关（比值比1.6，95%置信区间1.1 - 2.6）。在疼痛性TMD患者中，灾难化与疼痛强度（r = 0.458，p < 0.01）和功能受限（r = 0.294 - 0.321，p≤0.002）相关，但与疼痛部位数量无关。
与对照组相比，社区中患有疼痛性TMD的个体表现出更高水平的疼痛灾难化，且这种灾难化与疼痛强度增加和下颌功能障碍相关。疼痛灾难化得分相对较低表明，即使是轻微的灾难性思维也与疼痛感知和下颌功能有关，在患者管理中应予以考虑。
