van der Meer Hedwig A, Tol Cornel H M, Speksnijder Caroline M, van Selms Maurits K A, Lobbezoo Frank, Visscher Corine M
Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Eur J Oral Sci. 2023 Apr;131(2):e12919. doi: 10.1111/eos.12919. Epub 2023 Feb 19.
The objective of this study was to assess the association between psychosocial factors (in terms of anxiety, somatization, depression, and optimism) and pain (in terms of headache pain intensity and pain-related disability), in patients with a painful temporomandibular disorder (TMD) and one of the following headache types: migraine, tension-type headache (TTH), or headache attributed to TMD, corrected for the influence of bruxism. A retrospective study was conducted at an orofacial pain and dysfunction (OPD) clinic. Inclusion criteria were painful TMD, with migraine, TTH, and/or headache attributed to TMD. Linear regressions were performed to assess the influence of psychosocial variables on pain intensity and on pain-related disability, stratified per headache type. The regression models were corrected for bruxism and the presence of multiple headache types. A total of 323 patients (61% female; mean age 42.9, SD 14.4 years) were included. Headache pain intensity only had significant associations in TMD-pain patients with headache attributed to TMD, and anxiety showed the strongest relation (β = 0.353) with pain intensity. Pain-related disability was most strongly associated with depression in TMD-pain patients with TTH (β = 0.444), and with somatization in patients with headache attributed to TMD (β = 0.399). In conclusion, the influence of psychosocial factors on headache pain intensity and pain-related disability depends on the headache type presenting.
本研究的目的是评估在患有疼痛性颞下颌关节紊乱病（TMD）且伴有以下头痛类型之一（偏头痛、紧张型头痛（TTH）或归因于TMD的头痛）的患者中，心理社会因素（焦虑、躯体化、抑郁和乐观）与疼痛（头痛疼痛强度和疼痛相关残疾）之间的关联，并校正磨牙症的影响。在一家口腔面部疼痛与功能障碍（OPD）诊所进行了一项回顾性研究。纳入标准为患有疼痛性TMD，伴有偏头痛、TTH和/或归因于TMD的头痛。进行线性回归以评估心理社会变量对疼痛强度和疼痛相关残疾的影响，并按头痛类型分层。回归模型校正了磨牙症和多种头痛类型的存在。共纳入323例患者（61%为女性；平均年龄42.9岁，标准差14.4岁）。头痛疼痛强度仅在患有归因于TMD的头痛的TMD疼痛患者中有显著关联，焦虑与疼痛强度的关系最为密切（β = 0.353）。在患有TTH的TMD疼痛患者中，疼痛相关残疾与抑郁的关联最为强烈（β = 0.444），而在患有归因于TMD的头痛的患者中，与躯体化的关联最为强烈（β = 0.399）。总之，心理社会因素对头痛疼痛强度和疼痛相关残疾的影响取决于所呈现的头痛类型。
