Department of Orofacial Pain and Oral Medicine Kyung Hee University Dental Hospital, Kyung Hee University, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea.
Sci Rep. 2022 Aug 29;12(1):14667. doi: 10.1038/s41598-022-18745-0.
Temporomandibular disorders (TMD) are a multifactorial condition associated with both physical and psychological factors. Stress has been known to trigger or worsens TMD. We aimed to investigate whether the novel coronavirus disease-2019 (COVID-19) pandemic aggravates depression in patients with painful TMD, and the factors that affect their level of depression. We included 112 patients with painful TMD (74 females, 38 males; mean age: 35.90 ± 17.60 years; myalgia [n = 38], arthralgia [n = 43], mixed joint-muscle TMD pain [n = 31]). TMD was diagnosed based on the Diagnostic Criteria for TMD Axis I. Physical pain intensity was recorded using the visual analog scale (VAS); psycho-emotional status (depression: Beck Depression Inventory [BDI], anxiety: Beck Anxiety Inventory [BAI], and generalized stress related to COVID19: Global Assessment of Recent Stress [GARS]) was investigated twice (before [BC] and after COVID-19 [AC]). Additionally, factors affecting BDI-AC were investigated. BDI (p < 0.001), BAI (p < 0.001), GARS (p < 0.001), and VAS (p < 0.01) scores were significantly increased at AC than BC. The depression, anxiety, and stress levels were significantly positively correlated, and the AC and BC values of each factor showed a high correlation. In the mixed TMD group, BDI-AC was positively correlated with VAS-AC (p < 0.001). In the multiple regression analysis, clenching habit was the strongest predictor of an increase in the BDI scores from moderate to severe, followed by psychological distress, muscle stiffness, female sex, BAI-AC, and TMJ sounds. COVID-19 has negatively affected the psycho-emotional state of patients with painful TMD, and several clinical factors, including female sex and clenching habits, have influenced depression.
颞下颌关节紊乱病（TMD）是一种与生理和心理因素相关的多因素疾病。压力已被证实可引发或加重 TMD。本研究旨在探讨新型冠状病毒病-2019（COVID-19）大流行是否会加重患有疼痛性 TMD 患者的抑郁程度，以及影响其抑郁程度的因素。我们纳入了 112 例疼痛性 TMD 患者（74 名女性，38 名男性；平均年龄：35.90±17.60 岁；肌痛[n=38]，关节痛[n=43]，混合关节-肌肉 TMD 疼痛[n=31]）。TMD 基于 TMD 轴 I 的诊断标准进行诊断。使用视觉模拟量表（VAS）记录身体疼痛强度；两次调查心理-情绪状态（抑郁：贝克抑郁量表[BDI]，焦虑：贝克焦虑量表[BAI]，以及与 COVID19 相关的一般压力：近期压力评估量表[GARS]）（BC：大流行前，AC：大流行后）。此外，还探讨了影响 BDI-AC 的因素。与 BC 相比，AC 时 BDI（p<0.001）、BAI（p<0.001）、GARS（p<0.001）和 VAS（p<0.01）评分显著增加。抑郁、焦虑和压力水平呈显著正相关，且各因素的 AC 和 BC 值之间相关性较高。在混合 TMD 组中，BDI-AC 与 VAS-AC 呈正相关（p<0.001）。在多元回归分析中，紧咬牙习惯是 BDI 评分从中度到重度增加的最强预测因素，其次是心理困扰、肌肉僵硬、女性、BAI-AC 和 TMJ 声音。COVID-19 对疼痛性 TMD 患者的心理-情绪状态产生了负面影响，包括女性和紧咬牙习惯在内的一些临床因素影响了抑郁。
