Dworkin S F, Massoth D L
University of Washington, Seattle.
J Prosthet Dent. 1994 Jul;72(1):29-38. doi: 10.1016/0022-3913(94)90213-5.
Temporomandibular disorders (TMD) are examined from a biopsychosocial or illness perspective. Data are reviewed in accordance with the concept that TMD is a chronic pain condition that shares many features with other common chronic pain conditions. TMD is placed within the same biopsychosocial model currently used to study and manage all common chronic pain conditions. The concept of chronic pain dysfunction, which has emerged as a critical consideration for chronic pain research and management, is also reviewed. Most chronic pain patients seem to bear their condition adequately and thus maintain adaptive levels of psychosocial function. By contrast, a psychosocially dysfunctional segment of the chronic pain population appears unable to cope as well and demonstrate higher rates of depression, somatization, and health care use, even though persons in this segment are not different from their functional peers on the basis of observable organic pathology. Finally, data are reviewed from longitudinal, epidemiologic, and experimental intervention studies that substantiate these two perspectives.
颞下颌关节紊乱病（TMD）是从生物心理社会或疾病角度进行研究的。根据TMD是一种慢性疼痛疾病且与其他常见慢性疼痛疾病有许多共同特征这一概念对数据进行了综述。TMD被置于目前用于研究和管理所有常见慢性疼痛疾病的相同生物心理社会模型中。还对慢性疼痛功能障碍的概念进行了综述，该概念已成为慢性疼痛研究和管理的关键考量因素。大多数慢性疼痛患者似乎能充分忍受自身状况，从而维持心理社会功能的适应水平。相比之下，慢性疼痛人群中存在一部分心理社会功能失调者，他们似乎无法同样有效地应对，表现出更高的抑郁、躯体化和医疗保健使用率，尽管这部分人与功能正常的同龄人在可观察到的器质性病理方面并无差异。最后，对证实这两种观点的纵向、流行病学和实验性干预研究的数据进行了综述。
