Faculty of Dentistry, Oral & Craniofacial Science, King's College London, London, UK.
Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand.
J Oral Rehabil. 2024 Oct;51(10):2029-2042. doi: 10.1111/joor.13789. Epub 2024 Jul 4.
This study assessed the impact of migraine and fibromyalgia (FM) in TMD patients, focusing on pain, anxiety, depression, and quality of life (QoL). Additionally, we investigated how these variables relate to the total number of comorbidities to gain insights into their interactions.
A retrospective data collection was conducted during January 2016 to December 2022, involving 409 adult TMD patients. TMD patients were categorised into four groups: those without comorbidity (TMD-only) and those with comorbid migraine and/or fibromyalgia (TMD + MG, TMD + FM and TMD + MG + FM). Quantitative variables were compared among them. Linear regression was used to analyse the associations between these variables.
Most of study population were women (79%) with a mean age of 44.43 years. TMD + MG patients reported longer pain duration, higher pain scores and greater pain interference compared with TMD-only patients. Similarly, TMD + FM patients had higher pain intensity than patients with TMD only. Both the TMD + MG and TMD + FM groups had higher levels of anxiety, depression, and health impairment compared with patients with TMD only. Patients with all three pain conditions (TMD + MG + FM) experienced the longest pain duration, highest pain intensity, psychological distress, and impaired QoL. The result showed positive associations between pain outcomes, psychological measures, pain's impact on QoL, and the number of comorbidities and a negative association between overall health states and the number of comorbidities.
These findings underscore the importance of considering the presence of comorbidities and addressing physical and psychological aspects in the management of TMD patients.
本研究评估了偏头痛和纤维肌痛（FM）对 TMD 患者的影响，重点关注疼痛、焦虑、抑郁和生活质量（QoL）。此外，我们还研究了这些变量与共病总数的关系，以深入了解它们的相互作用。
本研究于 2016 年 1 月至 2022 年 12 月进行了回顾性数据收集，涉及 409 名成年 TMD 患者。将 TMD 患者分为四组：无共病（TMD 仅）和伴有共病偏头痛和/或纤维肌痛（TMD+MG、TMD+FM 和 TMD+MG+FM）的患者。比较它们之间的定量变量。采用线性回归分析这些变量之间的关系。
研究人群中大多数为女性（79%），平均年龄为 44.43 岁。与 TMD 仅患者相比，TMD+MG 患者的疼痛持续时间更长，疼痛评分和疼痛干扰更高。同样，TMD+FM 患者的疼痛强度高于 TMD 仅患者。TMD+MG 和 TMD+FM 组的焦虑、抑郁和健康损害程度均高于 TMD 仅患者。所有三种疼痛状况（TMD+MG+FM）的患者疼痛持续时间最长、疼痛强度最高、心理困扰最大，生活质量受损最严重。结果表明，疼痛结果、心理测量、疼痛对 QoL 的影响以及共病数量之间存在正相关，整体健康状况与共病数量之间存在负相关。
这些发现强调了在 TMD 患者的管理中考虑共病的存在和解决身体和心理方面的重要性。
