Psychosocial symptoms as predictors for persistent pain in temporomandibular disorder

Abstract

This longitudinal study of temporomandibular disorder (TMD) reports the association of psychosocial dysfunctions (depression, somatization without pain, somatization, and anxiety) with characteristic pain intensity, pain interference, and number of disability days (CPI, PI, DD) on subjects with TMD. Subjects (N=330) underwent a thorough series of assessments at baseline and follow up (5-10 years later) to receive both Axis I and Axis II diagnoses per the Research Diagnostic Criteria for TMD (RDC/TMD). They reported their levels of CPI, PI, and DD at baseline and follow-up. Linear and log-binomial regression analyses were used to evaluate the change in CPI and PI and assess the risk of DD by baseline categories of psychosocial symptoms as measured by the Symptom Checklist (SCL-90). Linear regression analysis revealed that subjects with depression at baseline had higher PI at follow-up. Also, subjects with moderate to severe somatization with and without pain had higher CPI at follow-up than subjects without somatization. Furthermore, among subjects with no DD at baseline, subjects with moderate to severe somatization without pain were more likely to have 1 or more DD at follow-up than subjects without somatization. In conclusion, we found that psychosocial impairments (depression, somatization) were associated with increased of characteristic of pain intensity, pain interference, and disability days at follow-up.