Somatic complaints, psychologic distress, and treatment outcome in two groups of TMD patients, one previously subjected to whiplash injury.

The aim of this study was to compare somatic complaints and psychologic distress in a group of whiplash patients with temporomandibular disorders (TMD) and a group of patients with TMD only, and to assess the outcome after conservative TMD treatment consisting of counseling, muscle exercises, and a stabilization splint. Each group consisted of 16 patients (12 women and 4 men) with a mean age of 42 years. The duration of the symptoms was from 1 to 3 years. In addition to a functional clinical examination and a recording of headache frequency and intensity, the patients answered three questionnaires: a Somatic Complaints Questionnaire (SCQ); the trait portion of Spielberger's State-Trait Anxiety Inventory; and the Symptom Checklist-90-Revised (SCL-90-R). The whiplash patients had higher scores than the TMD patients on the SCQ muscle score and on the following subscores of SCL-90-R: obsession, somatization, depression, and anger/hostility. The treatment outcome as assessed by the change of self-reported frequency of headache, number of tender muscles upon palpation, and change of values on a visual analogue scale for headache intensity showed that the whiplash patients obtained only a decrease in the proportion of tender muscles, while those in the TMD only group showed improvement on all treatment criteria.