Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore.
National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, National Dental Research Institute Singapore, Singapore, Singapore.
J Oral Rehabil. 2024 Dec;51(12):2566-2576. doi: 10.1111/joor.13857. Epub 2024 Sep 17.
The relationship of somatisation with facial pain duration/intensity, pain-related interference/disability and psychological distress was investigated in East Asian temporomandibular disorder (TMD) patients. Correlations between somatisation, facial pain and psychological characteristics were also explored alongside the demographic/physical factors associated with moderate-to-severe depression and anxiety.
Anonymised data were acquired from records of consecutive 'first-time' patients seeking TMD care at a tertiary oral medicine clinic. Axis I physical TMD diagnoses were established utilising the diagnostic criteria for TMDs (DC/TMD) protocol and patients with TMD pain were stratified into those with pain-related (PT) and combined (CT) conditions. Axis II measures administered encompassed the Patient Health Questionnaire-15 (PHQ-15), Graded Chronic Pain Scale (GCPS), Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder Scale-7 (GAD-7). Individuals with PT and CT were further categorised into those without (Pain - Som/Comb - Som) and with somatisation (Pain + Som/Comb + Som). Statistical evaluations were performed with nonparametric and logistic regression analyses (α = 0.05).
The final sample comprised 473 patients (mean age 36.2 ± 14.8 years; 68.9% women), of which 52.0% had concomitant somatisation. Significant differences in pain duration (Comb + Som > Pain - Som), pain-related interference/disability (Comb + Som > Comb - Som) and depression/anxiety (Pain + Som, Comb + Som > Pain - Som, Comb - Som) were discerned. Depression/anxiety was moderately correlated with somatisation (r = 0.64/0.52) but not facial pain characteristics. Multivariate modelling revealed that somatisation was significantly associated with the prospects of moderate-to-severe depression (OR 1.35) and anxiety (OR 1.24).
Somatisation exhibited a strong association with psychological distress when contrasted with facial pain in East Asian TMD patients.
本研究旨在探讨躯体化与东亚颞下颌关节紊乱病（TMD）患者面部疼痛持续时间/强度、疼痛相关干扰/残疾和心理困扰之间的关系。同时，还探讨了躯体化与面部疼痛以及心理特征之间的相关性，以及与中重度抑郁和焦虑相关的人口统计学/身体因素。
从一家三级口腔医学诊所接受 TMD 治疗的“首次”连续就诊患者的记录中获取匿名数据。利用 TMD 诊断标准（DC/TMD 方案）确定 I 轴躯体 TMD 诊断，将 TMD 疼痛患者分为与疼痛相关（PT）和混合（CT）两种情况。实施的 II 轴测量包括患者健康问卷-15 项（PHQ-15）、慢性疼痛分级量表（GCPS）、患者健康问卷-9 项（PHQ-9）和广泛性焦虑障碍量表-7 项（GAD-7）。将 PT 和 CT 患者进一步分为无躯体化（疼痛-躯体/混合-躯体）和躯体化（疼痛+躯体/混合+躯体）患者。使用非参数和逻辑回归分析进行统计评估（α=0.05）。
最终样本包括 473 名患者（平均年龄 36.2±14.8 岁；68.9%为女性），其中 52.0%伴有躯体化。在疼痛持续时间（混合+躯体>疼痛-躯体）、疼痛相关干扰/残疾（混合+躯体>混合-躯体）和抑郁/焦虑（疼痛+躯体，混合+躯体>疼痛-躯体，混合-躯体）方面存在显著差异。抑郁/焦虑与躯体化中度相关（r=0.64/0.52），但与面部疼痛特征无关。多变量建模显示，躯体化与中重度抑郁（OR 1.35）和焦虑（OR 1.24）的发生显著相关。
与东亚 TMD 患者的面部疼痛相比，躯体化与心理困扰具有更强的相关性。
