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Morris MC, Bruehl S, Rao U, Goodin BR, Karlson C, Carter C, Nag S, Huber FA, Bendinskas KG, Hidoyatov M, Kinney K, Rochelle A, Funches G. Biobehavioral Predictors of Pain Intensity, Pain Interference, and Chronic Pain Episodes: A Prospective Cohort Study of African-American Adults. THE JOURNAL OF PAIN 2024; 25:104501. [PMID: 38369220 PMCID: PMC11283993 DOI: 10.1016/j.jpain.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/19/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024]
Abstract
Racial disparities in pain experiences are well-established, with African-American (AA) adults reporting higher rates of daily pain, increased pain severity, and greater pain-related interference compared to non-Hispanic Whites. However, the biobehavioral factors that predict the transition to chronic pain among AA adults are not well understood. This prospective cohort study provided a unique opportunity to evaluate predictors of chronic pain onset among 130 AA adults (81 women), ages 18 to 44, who did not report chronic pain at their baseline assessment and subsequently completed follow-up assessments at 6- and 12-months. Outcome measures included pain intensity, pain-related interference, and chronic pain status. Comprehensive assessments of sociodemographic and biobehavioral factors were used to evaluate demographics, socioeconomic status, stress exposure, psychosocial factors, prolonged hypothalamic-pituitary-adrenal secretion, and quantitative sensory testing responses. At baseline, 30 adults (23.1%) reported a history of prior chronic pain. Over the 12-month follow-up period, 13 adults (10.0%) developed a new chronic pain episode, and 18 adults (13.8%) developed a recurrent chronic pain episode. Whereas socioeconomic status measures (ie, annual income, education) predicted changes in pain intensity over the follow-up period, quantitative sensory testing measures (ie, pain threshold, temporal summation of pain) predicted changes in pain interference. A history of chronic pain and higher depressive symptoms at baseline independently predicted the onset of a new chronic pain episode. The present findings highlight distinct subsets of biobehavioral factors that are differentially associated with trajectories of pain intensity, pain-related interference, and onset of chronic pain episodes in AA adults. PERSPECTIVE: This prospective study sought to advance understanding of biobehavioral factors that predicted pain outcomes over a 12-month follow-up period among AA adults without chronic pain at their initial assessment. Findings revealed distinct subsets of factors that were differentially associated with pain intensity, pain-related interference, and onset of chronic pain episodes.
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Affiliation(s)
- Matthew C. Morris
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
| | - Uma Rao
- Department of Psychiatry & Human Behavior and Center for the Neurobiology of Learning and Memory, University of California – Irvine, California, USA
- Psychiatry Division, Children’s Hospital of Orange County, Orange, CA, USA
| | - Burel R. Goodin
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO
| | - Cynthia Karlson
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
- Department of Hematology and Oncology, University of Mississippi Medical Center, Jackson, MS
| | - Chelsea Carter
- School of Medicine, Meharry Medical College, Nashville, TN
| | - Subodh Nag
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
| | - Felicitas A. Huber
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO
| | | | - Muhammad Hidoyatov
- Chemistry Department, State University of New York at Oswego, Oswego, NY
| | - Kerry Kinney
- Department of Psychology, Vanderbilt University, Nashville, TN
| | - Aubrey Rochelle
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
| | - Gaarmel Funches
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
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Son J, Kim ES, Lee YJ, Lee NW, Ha IH. Minimum clinically important difference and substantial clinical benefit in patients with chronic temporomandibular disorders. J Oral Rehabil 2024; 51:1468-1474. [PMID: 38706163 DOI: 10.1111/joor.13717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 12/07/2023] [Accepted: 04/18/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Research on temporomandibular disorder (TMD) responsiveness is scarce and limited regarding patients' representativeness. OBJECTIVE(S) This study aimed to estimate minimum clinically important difference (MCID) and substantial clinical benefit (SCB) among a large and diverse patient population regarding sex and age. METHODS In this study, 162 patients participated from five hospitals. MCID and SCB in pain, functional disability and quality of life were examined with anchor-based methods. Patients' global impression of change was used as the anchor. Area under the curve (AUC) values were determined for testing accuracy. Changes from baseline and coefficient of variation by responsiveness status were calculated to explain the results of accuracy. RESULTS SCB was estimated to be 2.18 for the numeric rating scale (NRS) for pain (AUC: 0.80 [95% CI: 0.72-0.88]) in all patients and 2.50 in women (AUC: 0.81 [95% CI: 0.71-0.89]). The estimated SCB of NRS for discomfort (1.50) and Jaw Functional Limitation Scale for mastication (1.35) had wide CIs for AUCs. Likewise, the estimated MCIDs of NRS for pain (0.80) and NRS for discomfort (1.50) had wide CIs for AUCs. Among non-responders who did not achieve the MCID of NRS for pain, the coefficient of variation was very high for all outcomes other than the NRS for pain. CONCLUSION This study investigated the responsiveness of patients with TMD using a large and diverse patient sample. SCB in pain decrease can be used to assess the responsiveness of patients with TMD. Composite outcomes should be developed to estimate MCID.
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Affiliation(s)
- Jaemin Son
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Eun-San Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Nam-Woo Lee
- Department of Korean Rehabilitation Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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Zeytin Demiral G, Türk Börü Ü, Bölük C, Acar H, İncebacak F. Prevalence of Trigeminal Neuralgia and Persistent Idiopathic Facial Pain in Afyonkarahisar, Türkiye. Neuroepidemiology 2024:1-7. [PMID: 38952106 DOI: 10.1159/000539831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/30/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Population-based studies examining the prevalence of trigeminal neuralgia (TN) and persistent idiopathic facial pain (PIFP) are rare, and data on TN prevalence in Türkiye are very limited, with the prevalence of PIFP being unknown. This study aimed to determine the prevalence of TN and PIFP in Türkiye. MATERIALS AND METHODS This population-based epidemiological study has a cross-sectional and descriptive design, and it was carried out in Afyonkarahisar, Türkiye. Participants aged 18 years and older were screened by using a self-assessment form to determine potential patients with TN or PIFP. RESULTS A total of 19,237 individuals were included in this study, of which 17,223 responded to the survey questions. TN was diagnosed in 17 individuals, and the prevalence of TN was calculated as 98.5 per 100,000. PIFP was diagnosed in 35 patients, and the prevalence of PIFP was calculated as 202 per 100,000. The mean age of the patients with TN was 54.29 ± 12.98 years, the mean age of patients with PIFP was 49.80 ± 16.10 years, and the female-to-male ratio was 1.13/1 for TN and 2.18/1 for PIFP. CONCLUSION The prevalence of PIFP in Türkiye has been reported for the first time by this study. Additionally, a much higher prevalence of TN was found when compared to previous study.
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Affiliation(s)
- Gökçe Zeytin Demiral
- Department of Neurology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ülkü Türk Börü
- Department of Neurology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Cem Bölük
- Clinic of Clinical Neurophysiology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Hakan Acar
- Department of Neurology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Furkan İncebacak
- Department of Neurology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Bof de Andrade F, Teixeira DSDC, Moreira RDS, de Oliveira C. Prevalence and associations of temporomandibular disorders in older Brazilian adults. Gerodontology 2024; 41:263-268. [PMID: 37386718 DOI: 10.1111/ger.12701] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE The objective of the study was to estimate the prevalence of temporomandibular disorders (TMD) and describe associations in a representative sample of community-dwelling older Brazilian adults. BACKGROUND TMD cause recurrent or chronic pain and dysfunction with substantial impacts on quality of life, but little is known of their occurrence and associated factors among older adults. MATERIALS AND METHODS This was a cross-sectional study using data from the second wave of the Brazilian Longitudinal Study of Aging, a nationally representative sample of older Brazilian adults aged 50 or older. The presence of temporomandibular disorder symptoms was measured by the Fonseca Anamnestic Index. Independent variables included sociodemographic characteristics, general health conditions and self-reported oral health measures. The association between the independent variables and TMD symptoms was evaluated using logistic regression models. RESULTS Complete information for the variables of interest was available for 9391 individuals. The overall prevalence of TMD symptoms was 18.0% (95% CI 14.4-22.1). Relative to older adults aged 50-59 those in all age categories had lower odds of TMD symptoms. Individuals with depression, pain, sleep problems and self-reported poor general health had higher odds of reporting TMD symptoms. None of the oral health measures were related to TMD. CONCLUSION The prevalence of TMD symptoms among Brazilian older adults is associated with demographic and general health conditions, but not with dentition status.
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Affiliation(s)
| | | | - Rafael da Silveira Moreira
- Instituto Aggeu Magalhães, Oswaldo Cruz Foundation, Recife, Brazil
- Center for Medical Science, Federal University of Pernambuco, Recife, Brazil
| | - Cesar de Oliveira
- Epidemiology and Public Health Department, University College London, London, UK
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Yao Y, Liu SS, Jin L, Zeng H, Jiang X, Fang ZY, Cai B, Xu L. Mental health and jaw function of patients with anterior disc displacement with reduction. J Oral Rehabil 2024; 51:677-683. [PMID: 38087998 DOI: 10.1111/joor.13637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/08/2023] [Accepted: 11/26/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND The mental health of patients with temporomandibular disorder or other jaw dysfunction is a primary concern in clinical practice, but the extent of these symptoms in this patient subset is not yet well understood. OBJECTIVES This cross-sectional study aimed to compare the mental health and jaw function between patients with anterior disc displacement with reduction (ADDWR) and healthy individuals. METHODS In total, 170 patients with ADDWR and 163 healthy participants enrolled in this study from March 2020 to December 2021. All participants completed a single assessment, including a pain rating and several questionnaires to assess jaw dysfunction, depression, and anxiety. All scores and the grade distribution of somatization, depression and anxiety were analysed between groups. RESULTS Significant differences were found in measures of pain, jaw function and somatization; the ADDWR group had significantly higher pain and functional jaw limitations than the healthy group. The grade distribution of somatic symptoms also differed between groups: the distribution of patients who reported mild and above scores in the ADDWR group was significantly higher than that of the healthy group. Depression and anxiety scores or grade distributions were not significantly different by group. CONCLUSION The jaw function of patients seeking treatment for ADDWR was lower than that of non-TMD individuals. They did not show high anxiety and depression symptoms, but their somatic symptoms were more apparent.
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Affiliation(s)
- Yuan Yao
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sha Sha Liu
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Jin
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Zeng
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Jiang
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhong Yi Fang
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Cai
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lili Xu
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yakkaphan P, Elias LA, Ravindranath PT, Renton T. Is painful temporomandibular disorder a real headache for many patients? Br Dent J 2024; 236:475-482. [PMID: 38519684 PMCID: PMC10959744 DOI: 10.1038/s41415-024-7178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 03/25/2024]
Abstract
Temporomandibular disorders (TMDs) and primary headaches are common pain conditions and often co-exist. TMD classification includes the term 'headache secondary to TMD' but this term does not acknowledge the likelihood that primary headache pathophysiology underpins headache causing painful TMD signs and symptoms in many patients. The two disorders have a complex link and we do not fully understand their interrelationship. However, growing evidence shows a significant association between the two disorders. This article reviews the possible connection between temporomandibular disorders and primary headaches, specifically migraine, both anatomically and pathogenetically.
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Affiliation(s)
- Pankaew Yakkaphan
- Faculty of Dentistry, Oral and Craniofacial Science, King´s College London, London, UK; Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand.
| | - Leigh-Ann Elias
- Orofacial Pain Service, Department of Oral Surgery, King´s College Hospital NHS Foundation Trust, London, UK
| | - Priya Thimma Ravindranath
- Faculty of Dentistry, Oral and Craniofacial Science, King´s College London, London, UK; Orofacial Pain Service, Department of Oral Surgery, King´s College Hospital NHS Foundation Trust, London, UK
| | - Tara Renton
- Faculty of Dentistry, Oral and Craniofacial Science, King´s College London, London, UK; Orofacial Pain Service, Department of Oral Surgery, King´s College Hospital NHS Foundation Trust, London, UK
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Warzocha J, Gadomska-Krasny J, Mrowiec J. Etiologic Factors of Temporomandibular Disorders: A Systematic Review of Literature Containing Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) from 2018 to 2022. Healthcare (Basel) 2024; 12:575. [PMID: 38470686 PMCID: PMC10931313 DOI: 10.3390/healthcare12050575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/17/2024] [Accepted: 02/25/2024] [Indexed: 03/14/2024] Open
Abstract
This study aims to conduct a systematic analysis of literature published between 1 January 2018 and 1 September 2022, exploring factors influencing the progression or development of temporomandibular disorders (TMD), diagnosed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Three electronic databases were reviewed to identify papers that examined TMD factors using DC/TMD or RDC/TMD. Inclusion criteria encompassed original research published in English between 1 January 2018 and 1 October 2022, online, and complete DC/TMD or RDC/TMD studies on human participants aged 18 or older. Two authors independently assessed the risk of bias using The Joanna Briggs Institute (JBI) Analytical cross-sectional studies' Critical Appraisal Tool. Of 1478 articles, 11 were included. The studies revealed strong associations between TMD and factors such as female, poor sleep quality, depression, oral parafunction, anxiety, somatization, and anatomical features. However, variables such as education, living conditions, socioeconomic status, marital status, chronic pain, and stress did not exhibit statistically significant correlations. Based on the obtained data, it can be concluded that the causes of TMD are largely related to psychological factors, which supports the biopsychosocial theory of the disorder.
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Affiliation(s)
- Joanna Warzocha
- Faculty of Medicine, Lazarski University, Świeradowska 43, 02-662 Warszawa, Poland
| | | | - Joanna Mrowiec
- SCS Astermed-Centrum Ortodontyczno-Implantologiczne, Świętego Bonifacego 92, 02-940 Warszawa, Poland
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Šklebar D, Šklebar I, Cesarik M, Čatipović V, Barada A, Milošević M, Bašić Kes V. MULTIDIMENSIONALITY AND MULTIDISCIPLINARITY OF CHRONIC NEUROPATHIC NONODONTOGENIC OROFACIAL PAIN. Acta Clin Croat 2023; 62:249-261. [PMID: 38549600 PMCID: PMC10969634 DOI: 10.20471/acc.2023.62.02.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/06/2020] [Indexed: 04/02/2024] Open
Abstract
This study compared the self-assessed health-related quality of life (HRQoL) and degree of depression between patients with chronic neuropathic nonodontogenic orofacial pain (NOFP) and healthy controls using the Short Form Survey (SF-36) health status questionnaire and Beck Depression Inventory II (BDI-II). This controlled cross-sectional study included 100 patients and 119 healthy controls. The diagnostic protocol recorded the following: 1) pain intensity using a visual analog scale for the time of examination and during the one-month prior; 2) evidence for neuropathic pain using the Leeds questionnaire for neuropathic signs and symptoms (LANSS); 3) emotional status using the BDI-II; and 4) HRQoL using the SF-36 questionnaire. The mean LANSS score was 17.18 in the patient group and 0.0 in the control group. The mean BDI-II score was 18.31 in the patient group and 5.87 in the control group. The SF-36 scores were shown with Mann-Whitney U testing to have statistically significant differences between the patient and healthy control groups in all categories. Vitality was the only SF-36 category in which the patient group scored higher than the control group. In conclusion, NOFP significantly reduces the self-reported HRQoL. NOFP is also related to the development of depression, but does not affect its severity. There is a significant correlation between depression and low quality of life in patients with NOFP.
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Affiliation(s)
- Duška Šklebar
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
- Bjelovar University of Applied Sciences, Bjelovar, Croatia
| | - Ivan Šklebar
- Outpatient Pain Clinic, Sveti Duh University Hospital, Zagreb, Croatia
- Croatian Catholic University, Zagreb, Croatia
- Bjelovar University of Applied Sciences, Bjelovar, Croatia
| | - Marijan Cesarik
- Department of Neurology, Požega General Hospital, Požega, Croatia
| | - Vinko Čatipović
- Department of Psychiatry, Bjelovar General Hospital, Bjelovar, Croatia
| | - Ante Barada
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
| | - Milan Milošević
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Vanja Bašić Kes
- Department of Neurology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
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Feng Y, Ou-Yang ZY, Lu JJ, Yang YF, Zhang Q, Zhong MM, Chen NX, Su XL, Hu J, Ye Q, Zhao J, Zhao YQ, Chen Y, Tan L, Liu Q, Feng YZ, Guo Y. Cross-cultural adaptation and psychometric properties of the Mainland Chinese version of the manchester orofacial pain disability scale (MOPDS) among college students. BMC Med Res Methodol 2023; 23:159. [PMID: 37415131 PMCID: PMC10324202 DOI: 10.1186/s12874-023-01976-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 06/13/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Orofacial pain (OFP) is a highly prevalent disorder in mainland China that predisposes to an associated physical and psychological disability. There is lack of a good properties mainland Chinese version of instrument to examine OFP. This study aims to cross-cultural adaptation and evaluate psychometrics properties of the Manchester Orofacial Pain Disability Scale (MOPDS) in mainland Chinese Mandarin context. METHODS Translation and cross-cultural adaption of the mainland Chinese version MOPDS were conducted following accepted guidelines of self-report measures. Chinese college students (N = 1039) completed the mainland Chinese version of the MOPDS for item analysis, reliability and validity tests, and measurement invariance analysis, and after a one-month interval, around 10% of the sample (n = 110) were invited to retest. To conduct the CFA and measurement invariance analysis, Mplus 8.4 was used. IBM SPSS Statistics 26 software were used for all additional studies. RESULTS We found that the mainland Chinese version of MOPDS contains 25 items, divided into two categories: physical disability and psychological disability. The scale demonstrated excellent internal reliability, test-retest reliability, and validity. The measurement invariance results proved that the scale could be applied to people of different gender, age, and health consultation status. CONCLUSIONS The results demonstrated the mainland Chinese version of MOPDS has good psychometric properties and can be used to measure the level of physical and psychological disability of Chinese OFP peoples.
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Affiliation(s)
- Yao Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Ze-Yue Ou-Yang
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Jing-Jie Lu
- Medical Psychological Center, the Second Xiangya Hospital of Central South University, Changsha, Hunan 410011 China
| | - Yi-Fan Yang
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Qian Zhang
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Meng-Mei Zhong
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Ning-Xin Chen
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Xiao-Lin Su
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Jing Hu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Qin Ye
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Jie Zhao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Ya-Qiong Zhao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Yun Chen
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Li Tan
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Qiong Liu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Yun-Zhi Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
| | - Yue Guo
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011 China
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Khan J, Singer SR, Young A, Tanaiutchawoot N, Kalladka M, Mupparapu M. Pathogenesis and Differential Diagnosis of Temporomandibular Joint Disorders. Dent Clin North Am 2023; 67:259-280. [PMID: 36965930 DOI: 10.1016/j.cden.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Temporomandibular disorders (TMDs) are an umbrella term including disorders of the temporomandibular joint and muscles of the masticatory system. They are the most common nonodontogenic cause of pain in the orofacial region. A clear understanding of various conditions, underlying mechanisms, clinical presentation, and examination skills is required to effectively diagnose and manage these patients.
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Affiliation(s)
- Junad Khan
- Orofacial Pain and TMJD, Eastman Institute for Oral Health, 625 Elmwood Avenue, Rochester, NY 14620, USA.
| | - Steven R Singer
- Department of Diagnostic Sciences Division of Oral & Maxillofacial Radiology, Rutgers School of Dental Medicine, 110 Bergen Street | PO Box 1709, Newark, NJ 07101-1709, USA
| | - Andrew Young
- Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA
| | - Naruthorn Tanaiutchawoot
- Department of Diagnostic Sciences Division of Oral & Maxillofacial Radiology, Rutgers School of Dental Medicine, 110 Bergen Street | PO Box 1709, Newark, NJ 07101-1709, USA
| | - Mythili Kalladka
- Orofacial Pain and TMJD, Eastman Institute for Oral Health, 625 Elmwood Avenue, Rochester, NY 14620, USA
| | - Mel Mupparapu
- Penn Dental Medicine, 240 S 40th Street, Philadelphia, PA 19104, USA
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Bidirectional Associations of Temporomandibular Joint Disorders with Major Depressive and Anxiety Disorders. J Evid Based Dent Pract 2023; 23:101860. [DOI: 10.1016/j.jebdp.2023.101860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/14/2023] [Accepted: 03/02/2023] [Indexed: 03/19/2023]
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12
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Depression, somatization, and sleep disorders as risk factors for temporomandibular disorders development. PSICO 2022. [DOI: 10.15448/1980-8623.2022.1.38434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The objective of this study was to determine the association between temporomandibular disorders (TMD) with depression, somatization and sleep disorders in the city of Maringá, Brazil. A total of 1,643 participants were selected from the Brazilian Unified Health System (SUS). Of these, the test group consisted of 84 participants who had moderate or severe limitations due to TMD pain and the control group consisted of 1,048 participants with no pain. There was a highly statistically significant difference (p<0.001) between cases and controls regarding depression (82.1 versus 37.4%), somatization (84.5 versus 31.4%), and sleep disorders (84.6 versus 36.4%), in moderate to severe levels. The levels of moderate to severe depression, somatization and sleep disorders were significantly higher in TMD subjects with high TMD pain disability. The risk of developing TMD increased 4 to 5 times when the individual has moderate to severe levels of depression, somatization, and sleep disorders.
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Salinas Fredricson A, Krüger Weiner C, Adami J, Rosén A, Lund B, Hedenberg-Magnusson B, Fredriksson L, Naimi-Akbar A. The Role of Mental Health and Behavioral Disorders in the Development of Temporomandibular Disorder: A SWEREG-TMD Nationwide Case-Control Study. J Pain Res 2022; 15:2641-2655. [PMID: 36097536 PMCID: PMC9464023 DOI: 10.2147/jpr.s381333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose There is a well-known association between mental and behavioral disorders (MBD) and temporomandibular disorder (TMD), although the association has not been established in population-based samples. This study aimed to investigate this relationship using national population-based registry data. Patients and Methods This case-control study used prospectively collected data from Swedish national registries to investigate exposure to MBD and the probability of developing TMD in all Swedish citizens with hospital-diagnosed or surgically treated TMD between 1998 and 2016. Odds ratios were calculated using conditional logistic regression adjusted for educational level, living area, country of birth, musculoskeletal comorbidity, and history of orofacial/neck trauma. Results A statistically significant association between MBD and TMD was found for mood affective disorders (OR 1.4), neurotic, stress-related and somatoform disorders (OR 1.7), behavioral syndromes associated with psychological disturbances and physical factors (OR 1.4), disorders of adult personality and behavior (OR 1.4), disorders of psychological development (OR 1.3), behavioral and emotional disorders with onset usually occurring in childhood and adolescence (OR 1.4), and unspecified mental disorder (OR 1.3). The association was stronger for TMD requiring surgery, with the strongest association in patients with disorders of psychological development (OR 2.9). No significant association was found with schizophrenia, schizotypal and delusional disorders, or mental retardation. Conclusion The findings indicate an increased probability of TMD among patients with a history of certain MBD diagnoses, and a stronger association with TMD requiring surgery, specifically repeated surgery. This highlights the need for improved preoperative understanding of the impact of MBD on TMD, as TMD and chronic pain itself may have a negative impact on mental health.
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Affiliation(s)
- Adrian Salinas Fredricson
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Stockholm, Sweden.,Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carina Krüger Weiner
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Stockholm, Sweden.,Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Annika Rosén
- Department of Clinical Dentistry, Division of Oral and Maxillofacial Surgery, University of Bergen, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Bodil Lund
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Medical Unit for Reconstructive Plastic and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Britt Hedenberg-Magnusson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Orofacial Pain and Jaw Function, Stockholm, Sweden
| | - Lars Fredriksson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Orofacial Pain and Jaw Function, Stockholm, Sweden
| | - Aron Naimi-Akbar
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Stockholm, Sweden.,Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
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14
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Karamat A, Smith JG, Melek LNF, Renton T. Psychologic Impact of Chronic Orofacial Pain: A Critical Review. J Oral Facial Pain Headache 2022; 36:103-140. [PMID: 35943323 PMCID: PMC10586586 DOI: 10.11607/ofph.3010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2023]
Abstract
AIMS To explore the prevalence of clinically significant anxiety and depression in adult patients with chronic orofacial pain (COFP) conditions. METHODS A systematic online search of the Medline (PubMed) and Ovid databases was performed for articles published from 2006 to 2019. Observational studies- including cross-sectional, case-control, and case series-and longitudinal prospective studies were included. A total of 118 articles were selected for inclusion, and the prevalence rates of clinically significant anxiety and depression were summarized. RESULTS Most studies focused on temporomandibular disorder (TMD) pain and less often on neuropathic COFP conditions. Prevalence rates varied widely across studies according to OFP condition and assessment measure; most questionnaire-based assessments yielded rates of clinically significant depression and anxiety in, respectively, 40% to 60% and 40% to 65% of individuals with TMD and in 20% to 50% and 25% to 55% of patients with neuropathic, mixed, or idiopathic/atypical COFP conditions. Rates of anxiety and depression were lower in studies using diagnostic instruments and in TMD studies with nonpatient samples. Most controlled studies showed a higher prevalence of anxiety and depression in individuals with COFP than in those without. Higher COFP pain levels and the presence of comorbid conditions such as migraines or widespread pain increased the likelihood of anxiety and/or depressive symptoms in individuals. CONCLUSION Clinically significant anxiety and depression were commonly observed in patients with COFP, were present at higher rates than in pain-free participants in controlled studies, and were closely linked to pain severity. More research is needed to evaluate the psychologic impact of multiple COFP conditions in an individual and the prevalence of precondition psychologic morbidity.
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15
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Lovette BC, Bannon SM, Spyropoulos DC, Vranceanu AM, Greenberg J. "I Still Suffer Every Second of Every Day": A Qualitative Analysis of the Challenges of Living with Chronic Orofacial Pain. J Pain Res 2022; 15:2139-2148. [PMID: 35935679 PMCID: PMC9346146 DOI: 10.2147/jpr.s372469] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/17/2022] [Indexed: 11/26/2022] Open
Abstract
Objective Chronic orofacial pain is prevalent and debilitating. Psychological and social factors place a heavy burden on this population but are often overlooked. Here, we offer the first comprehensive qualitative conceptualization of the challenges of living with chronic orofacial pain through a biopsychosocial perspective to inform multifaceted care for this population. Design We employed a qualitative thematic analysis of open text responses using a hybrid inductive-deductive approach and a biopsychosocial framework. Methods Two hundred and sixty participants with chronic orofacial pain responded to an open-ended question: "What is the biggest challenge you face in managing your condition?" by typing their responses into a text box as part of an online survey. We mapped responses onto biomedical, psychological, and social themes (deductive) and concurrently identified findings within each theme that emerged directly from the data (inductive). Results Subthemes within the biomedical theme included challenges with biomedical pain management, medication side effects, sensory triggers, physical symptoms of stress/tension, and biological functions and related activities of daily living. Subthemes within the psychological theme included anxiety, depression, emotional symptoms of stress, unpredictability/uncertainty of pain, and psychological and cognitive aspects of medication management. Subthemes within the social theme included social relational, experience with providers, socioeconomics and access to care, and roles and responsibilities. Conclusion Chronic orofacial pain is associated with multifaceted challenges. Consideration of individuals' experiences of biomedical, psychological, and social challenges in the assessment, referral, and treatment of chronic orofacial pain holds the potential to promote more comprehensive, patient-centered care for this population.
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Affiliation(s)
- Brenda C Lovette
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sarah M Bannon
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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16
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De Campos TT, Katekawa L, Shinkai RSA, Furuyama RJ, Missaka R, Mita D, De Oliveira APL. Self-Medication Profile of Adult Patients with Temporomandibular Disorders in Southeast Brazil. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:990-998. [PMID: 36407742 PMCID: PMC9643244 DOI: 10.18502/ijph.v51i5.9414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/15/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Patients with temporomandibular disorder (TMD) often have orofacial pain and may use medication without professional prescription. Self-medication and inappropriate drug intake may cause serious health problems. This cross-sectional study evaluated the self-medication profile of TMD patients, the most used medications and their effect, and the relation between self-medication and socioeconomic factors. METHODS A non-representative sample (n=358) consisted of consecutive adult patients seeking TMD treatment in specialized referral centers for orofacial pain of two universities in São Paulo city, Brazil. A standardized questionnaire was used to collect the study variables before the TMD treatment: self-medication history, TMD pain intensity, sex, age, ethnicity, marital status, schooling and socioeconomic levels. Data were analyzed by descriptive statistics, chi-square test, and logistic regression models at the 0.05 significance level. RESULTS Almost 60% of 358 TMD patients reported self-medication. Patients with severe TMD were 4.7 times more likely to self-medicate when compared to patients with low TMD intensity (O=5.7; 95% CI=2.4; 13.3; P=0.043), as well as female patients were 30% more likely to self-medicate compared to male patients (OR=2.3; 95% CI=1.1; 5.1; P<0.001). The other independent variables were not associated with self-medication. The frequencies of moderate and severe TMD in women were larger than in those in men (P<0.001). Analgesics and anti-inflammatory drugs were the most used medications. Regarding medication efficacy, 82% of patients reported some improvement after use, but 9% reported side-effect sickness. CONCLUSION Self-medication is common among TMD patients attending specialized clinics, and this inappropriate practice is more likely to occur in women and in patients with severe signs and symptoms of TMD.
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Affiliation(s)
- Tomie T. De Campos
- Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Lena Katekawa
- Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Rosemary S. A. Shinkai
- Postgraduate Program in Dentistry, School of Health and Life Sciences, Pontifical University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ricardo J. Furuyama
- Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Reinaldo Missaka
- Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Daniela Mita
- Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ana Paula L. De Oliveira
- Postgraduate Program in Biophotonics Applied to Health Sciences, University Nove de Julho, São Paulo, Brazil
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17
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Jung SY, Kim E, Kim K, Cho J, Lee YJ, Ha I. Treatment for temporomandibular disorders in South Korea: a 9‐year trend using cluster analysis. J Oral Rehabil 2022; 49:691-700. [DOI: 10.1111/joor.13333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 03/13/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Sung Yub Jung
- Jaseng Hospital of Korean Medicine 536 Gangnam‐daero, Gangnam‐gu Seoul 06110 Republic of Korea
| | - Eun‐San Kim
- Jaseng Spine and Joint Research Institute Jaseng Medical Foundation 3F, 538 Gangnam‐daero, Gangnam‐gu Seoul 06110 Republic of Korea
| | - Koh‐Woon Kim
- Department of Korean Rehabilitation Medicine College of Korean Medicine Kyung Hee University Seoul Republic of Korea
| | - Jae‐Heung Cho
- Department of Korean Rehabilitation Medicine College of Korean Medicine Kyung Hee University Seoul Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute Jaseng Medical Foundation 3F, 538 Gangnam‐daero, Gangnam‐gu Seoul 06110 Republic of Korea
| | - In‐Hyuk Ha
- Jaseng Spine and Joint Research Institute Jaseng Medical Foundation 3F, 538 Gangnam‐daero, Gangnam‐gu Seoul 06110 Republic of Korea
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18
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Greenberg J, Bakhshaie J, Lovette BC, Vranceanu AM. Association Between Coping Strategies and Pain-Related Outcomes Among Individuals with Chronic Orofacial Pain. J Pain Res 2022; 15:431-442. [PMID: 35177932 PMCID: PMC8846621 DOI: 10.2147/jpr.s350024] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/16/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
- Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Correspondence: Jonathan Greenberg, Integrated Brain Health Clinical and Research Program & Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, One Bowdoin Square, 1st Floor, Suite 106, Boston, MA, 02114, USA, Email
| | - Jafar Bakhshaie
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Brenda C Lovette
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- MGH Institute of Health Professions, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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19
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Durham J, Breckons M, Vale L, Shen J. DEEP Study: Modeling Outcomes and Costs of Persistent Orofacial Pain. JDR Clin Trans Res 2021; 8:23800844211063870. [PMID: 34915751 PMCID: PMC9773005 DOI: 10.1177/23800844211063870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
KNOWLEDGE OF TRANSFER STATEMENT Despite a substantial number of consultations, individuals experiencing the care pathways in this study continued to have far from perfect health over their life course. The modeling suggests they would only experience 18 y in "perfect health." There is considerable scope to improve current care/outcomes and patient experience.
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Affiliation(s)
- J. Durham
- School of Dental Sciences, Newcastle University, Newcastle, UK
- Health Economics Group, Newcastle University Population Health Sciences Institute, Newcastle, UK
- Newcastle Dental Hospital, Newcastle-Upon-Tyne Hospitals’ NHS Foundation Trust, Newcastle, UK
| | - M. Breckons
- Health Economics Group, Newcastle University Population Health Sciences Institute, Newcastle, UK
| | - L. Vale
- Health Economics Group, Newcastle University Population Health Sciences Institute, Newcastle, UK
| | - J. Shen
- Health Economics Group, Newcastle University Population Health Sciences Institute, Newcastle, UK
- Current affiliation: GSK Belgium, Wavre, Belgium
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20
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Sabsoob O, Elsaraj SM, Gornitsky M, Laszlo E, Fricton JR, Schiffman EL, Velly AM. Acute and Chronic Temporomandibular Disorder Pain: A critical review of differentiating factors and predictors of acute to chronic pain transition. J Oral Rehabil 2021; 49:362-372. [PMID: 34800343 DOI: 10.1111/joor.13283] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 11/01/2021] [Accepted: 11/06/2021] [Indexed: 11/28/2022]
Abstract
AIMS The aims of this critical review were to: (i) assess the factors that differentiate acute from chronic temporomandibular disorders (TMD) pain; (ii) assess the risk factors associated with the transition from acute to chronic TMD pain; and (iii) summarize and appraise the studies. METHOD The databases used were MEDLINE, Embase, and Cochrane Database of Systematic Reviews. Eligible studies included articles comparing acute to chronic TMD pain, and cohort studies assessing the risk factors implicated in the transition from acute to chronic TMD pain. RESULTS Seven articles were selected: one case-control study, three cross-sectional studies, and three cohort studies. These studies found that psychological factors were more common in chronic than acute TMD pain patients; however, these factors did not increase the transition risk in the multivariable model. Myofascial and baseline pain intensity were associated with the transition from acute to chronic TMD pain at a 6-month follow-up. Due to methodological weaknesses in the available literature, more research is required to establish the risk factors implicated in the transition from acute to chronic TMD pain. CONCLUSION This review found some evidence that myofascial pain is associated with the transition risk from acute to chronic TMD pain at a 6-month follow-up and that pain intensity at baseline is associated with more intense TMD pain 6 months later. There is insufficient evidence to draw conclusions about the role of demographics and psychological disorders as independent risk factors.
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Affiliation(s)
- Omar Sabsoob
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sherif M Elsaraj
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Mervyn Gornitsky
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Elise Laszlo
- Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
| | - James R Fricton
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA.,Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Eric L Schiffman
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ana M Velly
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
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21
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Sanner F, Sonntag D, Hambrock N, Zehnder M. Patients with persistent idiopathic dentoalveolar pain in dental practice. Int Endod J 2021; 55:231-239. [PMID: 34792207 PMCID: PMC9300172 DOI: 10.1111/iej.13664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 11/27/2022]
Abstract
Aim To assess whether persistent idiopathic dentoalveolar pain (PIDAP), a diagnosis of exclusion, exhibits common features that can facilitate its diagnosis. PIDAP is defined by the International Classification of Orofacial Pain (ICOP 6.3.) as ‘Persistent unilateral intraoral dentoalveolar pain, rarely occurring in multiple sites, with variable features but recurring daily for more than 2 h per day for more than 3 months, in the absence of any preceding causative event’. Methodology In this observational study, participants fulfilling the new ICOP diagnostic criteria of PIDAP were included, covering 16 years of consecutive data. A systematic, retrospective assessment of patients utilizing the new PIDAP criteria on complaints of chronic tooth pain in a referral‐based endodontic practice was undertaken. Non‐idiopathic cases were excluded on the basis of clinical and radiologic findings. A modified neuropathic pain questionnaire was used to describe the painful sensations. Furthermore, allodynia in the periodontal space and sensory changes in the oral mucosa were assessed using a periodontal probe. Results Amongst the 160 patients assessed, 78 (63 women) fulfilled the strict PIDAP criteria. Pain history of PIDAP included no nocturnal awakening (85%) and a ‘pulling/dragging’ pain quality (59%). In 69% of the patients with PIDAP, pain was associated with a root filled tooth at the same site. In 14% of the cases, no endodontic treatment was performed in the affected quadrant. Mechanical allodynia in the gingival sulcus was observed in 91% of patients with painful teeth or implants. Conclusions In this observational study, PIDAP mainly affected females and was associated with undisturbed sleep and periodontal allodynia.
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Affiliation(s)
| | - David Sonntag
- Carolinum, Clinic of Conservative and Preventive Dentistry, Frankfurt am Main, Germany
| | | | - Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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22
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Brazenor GA, Malham GM, Teddy PJ. Can Central Sensitization after injury persist as an autonomous pain generator? - A comprehensive search for evidence. PAIN MEDICINE 2021; 23:1283-1298. [PMID: 34718773 DOI: 10.1093/pm/pnab319] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/11/2021] [Accepted: 10/21/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To conduct a comprehensive search for evidence whether Central Sensitization following an injury can act as a persistent autonomous pain generator after the inducing injury has healed. METHODS We searched Medline on PubMed and the Cochrane Library, screening 3,572 abstracts, from which 937 full text articles were obtained, with 186 of these discarded as irrelevant to the question being posed. The remaining 751 articles were studied for evidence. RESULTS Fourteen publications were judged to provide weak evidence for the hypothesis of central sensitization as a persisting autonomous pain generator, but none addressed the question directly. No strong evidence for the affirmative answer was found.Sixty-two publications were judged to provide weak evidence for a negative answer, and nine judged to provide strong evidence.Unexpectedly, serious weaknesses were discovered in the literature underpinning the validity of the clinical diagnosis of Central Sensitization in man:(i) Inappropriate extrapolation, in many publications, of laboratory animal data to humans.(ii) Failure to demonstrate the absence of peripheral pain generators which might be perpetuating Central Sensitization.(iii) Many factors now shown to confound what is being measured by quantitative sensory testing, conditioned pain modulation, and Central Sensitization Inventory. CONCLUSIONS We found no evidence proving that central sensitization can persist as an autonomous pain generator after the initiating injury has healed.Our review has also shown that the evidential basis for the diagnosis of CS in individual patients is seriously in question.
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Affiliation(s)
| | | | - Peter J Teddy
- Royal Melbourne Hospital, Parkville, Victoria, Australia
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23
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Erdogan O, Ramsey A, Uyanik JM, Gibbs JL, Burns LE. Outcomes of referrals from endodontic to orofacial pain specialists: A retrospective cohort study. Clin Exp Dent Res 2021; 8:457-463. [PMID: 34623771 PMCID: PMC8874062 DOI: 10.1002/cre2.497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/11/2021] [Accepted: 08/25/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Diagnosis and treatment of non-odontogenic pain is challenging for endodontists. The purpose of the study was to investigate the outcomes of referrals to orofacial pain specialists made for patients with suspected non-odontogenic pain, after evaluation and/or treatment by an endodontist. MATERIALS AND METHODS A retrospective review of dental records was conducted for 60 patients referred from a postgraduate endodontic clinic to an orofacial pain clinic. Patient demographics, pain history, endodontic, and orofacial pain diagnoses were collected. Number of visits, length of treatment, and treatments prescribed were recorded. For analysis of outcomes, data pertinent to resolution/persistence of symptoms and patient compliance were analyzed. RESULTS Thirty-five patients were included in the study. The most frequent pulpal and periapical diagnoses were previously treated (62%) and symptomatic apical periodontitis (72%), respectively. The most common orofacial pain diagnosis was temporomandibular disorder. The average time spent to diagnose and treat the pain was 17 months. Pain reduction varied and was documented for 51% of patients. Indications of non-compliance with orofacial pain appointments and treatments were documented for 66% of patients. CONCLUSIONS Non-odontogenic pain diagnosis and treatment are challenging. Patients may have an increased predilection for developing persistent pain after endodontic treatment and/or have an undiagnosed, chronic orofacial pain condition as a true source of their chief complaint. It may be helpful for endodontists to set expectations of typical treatment times/plans when referring patients for evaluation and treatment of non-odontogenic pain.
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Affiliation(s)
- Ozge Erdogan
- Department of Endodontics, College of DentistryNew York UniversityNew YorkNew YorkUSA
- Division of Endodontics in Restorative Dentistry and Biomaterials SciencesHarvard School of Dental MedicineBostonMassachusettsUSA
| | - Austin Ramsey
- Department of Endodontics, College of DentistryNew York UniversityNew YorkNew YorkUSA
| | - James M. Uyanik
- Department of Oral and Maxillofacial Pathology, Radiology and MedicineCollege of Dentistry, New York UniversityNew YorkNew YorkUSA
| | - Jennifer L. Gibbs
- Division of Endodontics in Restorative Dentistry and Biomaterials SciencesHarvard School of Dental MedicineBostonMassachusettsUSA
| | - Lorel E. Burns
- Department of Endodontics, College of DentistryNew York UniversityNew YorkNew YorkUSA
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24
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Aggarwal VR, Wu J, Fox F, Howdon D, Guthrie E, Mighell A. Implementation of biopsychosocial supported self-management for chronic primary oro-facial pain including temporomandibular disorders: A theory, person and evidence-based approach. J Oral Rehabil 2021; 48:1118-1128. [PMID: 34273180 DOI: 10.1111/joor.13229] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Aims of the study were to: Implement supported self-management for chronic primary oro-facial pain in a clinical setting. Evaluate its impact on consultation rates, pain severity, interference with life and patient experience. METHODS Sixty-six patients with chronic primary oro-facial pain received the intervention at a facial pain clinic at Leeds Dental Institute, UK. Brief Pain Inventory (BPI) scores measured pain severity and interference with life before and after the intervention. Process mining outlined patient care pathways. Monthly consultation rates measured 12 months before and after the intervention were used to evaluate burden on healthcare services and economic impact. Patient feedback was assessed via Patient and Public involvement discussion groups. RESULTS Mean BPI scores significantly improved after intervention-from 5.70 (SD 1.89) to 3.78 (SD 2.34) (p < .001); mean pain interference score reduced from 19.95 (SD 9.41) to 12.05 (SD 9.64) (p < .001). Average monthly consultations significantly (p = .001) reduced from 0.42/month before the intervention to 0.16/month after the intervention. Economic assessment showed cost savings of £293 per patient per year. Process mining showed high rates of service usage with 31 patients also attending 51 other specialist services between them. Patient and Public Involvement discussion groups with 5 patients identified that the intervention was a 'constant companion' and should be implemented at the outset in the care pathway. CONCLUSION Supported self-management for chronic primary oro-facial pain has a positive impact on health outcomes (physical functioning, pain intensity and patient experience), as well as service usage and healthcare costs when implemented in a secondary care clinical setting. Reconfiguring current care pathways to upscale early implementation of such interventions should be a priority for future testing.
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Affiliation(s)
- Vishal R Aggarwal
- School of Dentistry, Faculty of Medicine & Health, University of Leeds, Leeds, UK
| | - Jianhua Wu
- School of Dentistry, Faculty of Medicine & Health, University of Leeds, Leeds, UK
| | - Frank Fox
- School of Dentistry, Faculty of Medicine & Health, University of Leeds, Leeds, UK
| | - Daniel Howdon
- Faculty of Medicine & Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Elspeth Guthrie
- Faculty of Medicine & Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Alan Mighell
- School of Dentistry, Faculty of Medicine & Health, University of Leeds, Leeds, UK
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Understanding the relationship between features associated with pain-related disability in people with painful temporomandibular disorder: an exploratory structural equation modeling approach. Pain 2021; 161:2710-2719. [PMID: 32639367 DOI: 10.1097/j.pain.0000000000001976] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pain-related disability is a multifaceted construct that refers to the impact of pain on an individual's capacity to fulfill their self-defined and social roles. This research examined the relationship between clinical, psychological, and pain sensitivity factors and pain-related disability among adults with chronic temporomandibular disorder (TMD). We analyzed data from a cross-sectional community-based sample of 1088 men and women with chronic TMD. We first constructed and tested a measure of pain-related disability (ie, pain impact), including a variable assessing presenteeism, created measurement models of jaw limitation, psychological unease (negative affect, somatic symptoms, and catastrophizing), and experimental pain sensitivity (eg, pressure pain threshold, thermal tolerance, and mechanical pressure pain threshold). Subsequently, latent variables were combined in a structural equation model. Participants (n = 1088) were 18 to 44 years old (mean 29.2, SD ± 7.8) whose chronic TMD had persisted, on average, for 6.9 years (SD ± 6.4). A model of pain-related disability, jaw limitation, and psychological unease was created and refined with exploratory model revisions to account for correlation among variables. Estimation of the final model indicated excellent fit with the data (root-mean-square error of approximation = 0.048, root-mean-square error of approximation 90% confidence interval [CI] 0.043-0.053, comparative fit index = 0.956, standardized root-mean-square residual = 0.040). Jaw functional limitation and psychological unease was strongly related to pain-related disability. Experimental pain sensitivity was removed from our model because of weak direct effect and the burden of performing experimental pain sensitivity testing in a clinical setting. The final model explained 78% of the variance in pain-related disability.
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Chen H, Pendleton C, Caplan DJ, Xie XJ. Chairside risk assessment for first-onset temporomandibular disorders: Result from the Orofacial Pain: Prospective Evaluation and Risk Assessment data set. J Am Dent Assoc 2021; 152:505-513.e2. [PMID: 33965199 DOI: 10.1016/j.adaj.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/25/2021] [Accepted: 02/21/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) risk assessment is difficult in general dentistry owing to the complexity of multifactorial risk contributions and the lack of standardized education. The authors explored a health history-based chairside risk assessment. METHODS Secondary data analysis was performed on the Orofacial Pain: Prospective Evaluation and Risk Assessment data set. Potential demographic, systemic, and local risk contributors were conceptualized into 10 risk categories. Multivariate Cox proportional hazards modeling with backward selection was applied. Variables with P values < .05 were kept in each successive model. RESULTS The analysis included data from 2,737 participants. The final model indicated that people with any psychological conditions, pain disorders, sleep disorders, or orofacial symptoms were at elevated risks of developing first-onset TMD. Results of post hoc analysis showed the coexistence of conditions from multiple body systems conferred greater risk of developing TMD. CONCLUSIONS Coexisting conditions and symptoms from multiple body systems substantially increase the risk of developing TMD pain. Therefore, multisystem risk assessment and interprofessional collaborations are important for the prevention of TMD. PRACTICAL IMPLICATIONS Dentists should include psychological conditions, pain disorders, sleep disorders, and orofacial symptoms when assessing patients' risk of developing TMD pain.
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The prevalence of depressive and anxiety symptoms and their associations with quality of life among clinically stable older patients with psychiatric disorders during the COVID-19 pandemic. Transl Psychiatry 2021; 11:75. [PMID: 33500389 PMCID: PMC7835649 DOI: 10.1038/s41398-021-01196-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 01/30/2023] Open
Abstract
The impact of the COVID-19 pandemic on clinically stable older patients with psychiatric disorders is unclear. This study examined the prevalence of depressive and anxiety symptoms, and their associations with quality of life (QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 pandemic. This was a multicenter, cross-sectional study. Depressive and anxiety symptoms, insomnia, pain, and QOL were assessed with standardized instruments. A total of 1063 patients were included. The prevalence of depressive and anxiety symptoms, and combined depressive and anxiety symptoms were 62.3% (95%CI = 59.4-65.2%), 52.4% (95%CI = 49.3-55.4%), and 45.9% (95%CI = 42.9-48.9%), respectively. Patients with depressive and anxiety symptoms had significantly lower QOL than those without (P < 0.01). Binary logistic regression analyses revealed that having depressive symptoms was positively associated with more severe insomnia (OR = 1.29, P < 0.01) and pain (OR = 1.14, P < 0.01), and was negatively associated with other psychiatric diagnoses (except for major depressive disorder, schizophrenia, and organic mental disorder; OR = 0.50, P < 0.01), while having anxiety symptoms was positively associated with severe physical diseases (OR = 1.57, P = 0.02), poor adherence to treatment (OR = 1.50, P < 0.01), and more severe insomnia (OR = 1.15, P < 0.01) and pain (OR = 1.11, P < 0.01). Having combined depression and anxiety symptoms was positively associated with poor adherence to treatment (OR = 1.42, P = 0.02) and more severe insomnia (OR = 1.19, P < 0.01) and pain (OR = 1.15, P < 0.01), and was negatively associated with the diagnosis of schizophrenia (OR = 0.50, P = 0.04) and others (OR = 0.53, P < 0.01). Depressive and anxiety symptoms were common in clinically stable older patients with psychiatric disorders during the COVID-19 pandemic. Considering the negative impact of these symptoms on QOL, regular screening and appropriate treatment are recommended for this population.
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Bai B, Bai X, Wang C. Mapping research trends of temporomandibular disorders from 2010 to 2019: A bibliometric analysis. J Oral Rehabil 2021; 48:517-530. [PMID: 33386626 DOI: 10.1111/joor.13143] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/21/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Because of various clinical manifestations and complicated courses, temporomandibular disorders (TMDs) are difficult to treat. Current knowledge about this disease remains insufficient for precise treatment after diagnosis. OBJECTIVES The objective of this study is to obtain and map the overall literature trends and most cited keywords in TMDs research. METHODS Many indicators, including annual number of publications, country distribution, global cooperations, author contributions, original journals, cited references and keywords, were calculated and evaluated using VOSviewer v.1.6.13, which visualised many results, from the WoSCC database. RESULTS A total of 3121 papers on TMDs research were retrieved from 2010 to 2019. The United States produced the most articles published, but the most productive institution was the University of Sao Paulo (Brazil). Researchers and institutions conducting TMDs research have shown a very widespread and close connection. TMDs have been studied worldwide by many research centres. Professor Svensson P was the most published researcher in TMDs research and the Journal of Oral Rehabilitation published the most TMDs research articles. The top cited references mainly presented diagnostic criteria of TMDs. The most cited keywords formed clusters: (a) Anatomical factor of TMDs, (b) Symptoms of TMDs and (c) RDC/TMD, the risk factors, biopsychosocial factors and epidemiology of TMDs. CONCLUSIONS The research results provide very valuable data for a thorough understanding of the research status of TMDs and demonstrated international cooperation.
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Affiliation(s)
- Bing Bai
- Department of Prosthodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Xiaofeng Bai
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Chunxia Wang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Lens Research Laboratory of Liaoning Province, Shenyang, China
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Bhalang K, Steiger B, Lukic N, Zumbrunn Wojczyńska A, Hovijitra RS, Ettlin DA. The Pain-to-Well-Being Relationship in Patients Experiencing Chronic Orofacial Pain. Front Neurol 2020; 11:557415. [PMID: 33343482 PMCID: PMC7744627 DOI: 10.3389/fneur.2020.557415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/26/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction: Orofacial pain features may negatively influence a person's well-being and vice versa. Some aspects of well-being can be measured with axis II instruments that assess patients' psychosocial and behavioral status. The aim of this study was to investigate associations between pain features and psychosocial variables as indicators of well-being. Materials and Methods: Seven hundred ninety-nine anonymized datasets collected using the Web-based Interdisciplinary Symptom Evaluation (WISE) of patients reporting to the Interdisciplinary Orofacial Pain Unit, University of Zurich, between March 19, 2017 and May 19, 2019, were analyzed. Pain features including intensity, number of locations, impact, and duration were evaluated. Psychometric measures assessed pain-related catastrophizing and disability, illness perception, distress, anxiety, depression, injustice experience, dysmorphic concerns, and insomnia. Results: Most patients were between 30 and 59 years old (58.3%), female (69.8%), working (66.0%), and experienced pain for more than 6 months (68.5%). Pain intensities were higher in women than men and higher in disabled than working patients. Scores indicating elevated stress and depression were also observed in disabled patients. The sample prevalence rates of clinically relevant axis II instrument scores were as follows: Graded Chronic Pain Scale for the Head (GCPS-H), 27%; Patient Health Questionnaire 4 (PHQ4), 21%; PHQ9, 21%; Pain Catastrophizing Scale (PCS), 20%; General Anxiety Disorder 7 (GAD7), 15%; Insomnia Severity Index (ISI), 15%; Injustice Experience Questionnaire (IEQ), 14%; GCPS for the Body (GCPS-B), 13%; PHQ for Stress (PHQstr), 6%; and Dysmorphic Concern Questionnaire (DCQ), 2%. Noteworthy results of correlation analysis of the clinically relevant axis II scores and pain measures were as follows: the PHQstr had moderate associations (0.34-0.43) with the sum of pain intensity at rest and during function, number of pain locations, and typical pain intensity. The IEQ scores were moderately associated with typical pain intensity at 0.39. The DCQ scores were moderately associated with pain extension at 0.41. Conclusions: Moderate correlations of certain pain and well-being measures were found in patients reporting clinically relevant stress, injustice experience, and dysmorphic concern, all of which reflect impaired well-being. PHQ4 is suitable for routine distress screening in the clinical setting.
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Affiliation(s)
- Kanokporn Bhalang
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Beat Steiger
- Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Aarau, Switzerland
| | - Nenad Lukic
- Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | | | - Ray S Hovijitra
- Dental Center, Bumrungrad International Hospital, Bangkok, Thailand
| | - Dominik A Ettlin
- Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,São Leopoldo Mandic Institute and Research Center, São Paulo, Brazil.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland
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Gaballah K, Alkubaisy A, Baker AA, Bawzeer A, Awad R. Revisiting the Risk Factors for Multiple Symptoms of Temporomandibular Disorders: A structured Cross-sectional Study. Open Dent J 2020. [DOI: 10.2174/1874210602014010503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The risk factors for Temporomandibular Disorders (TMD) are extensively studied, but the results showed no consistency. Only a small proportion of patients with TMD are likely to seek help and require treatment. Those individuals tend to present with multiple symptoms. This cohort of patients was not well investigated.
Objective:
The study aimed to examine the association between possible risk factors for presentation with multiple TMD symptoms.
Methods:
A population-based, cross-sectional study was conducted across 2101 individuals with an age range of 19-60 years. The condition was assessed via a detailed questionnaire comprising symptoms, habits, dental history, general health, sleep patterns, along with the completion of the Hospital Anxiety and Depression (HAD) scale, followed by an examination of the hypothesized clinical signs. The obtained data were tabulated and characterized the study population in a descriptive analysis in forms of percentages and frequencies. The significance level was set at P-value less than or equal to 0.005. The chi-squared test was implemented to assess the relationship between the multiple TMD symptoms reported and the potential risk factors.
Results:
Most participants reported a variable amount of stress. Moreover, 1528 (72.7 percent) mentioned abnormalities in sleep. About 80 percent had at least one TMD-related symptom. The multiple symptoms of TMD were identified among the 741 individuals. The following risk factors demonstrated association with a robust statistical significance (P=0.00), 1) occupation, 2) sleeping problems, 3) health concerns, 4) traumatic dental treatment, 5) various somatic symptoms, and 6) elevated HAD scale. When the outcomes of the clinical examination were analyzed, the statistical assessment could link soft tissue changes, namely; the cheek ridging and tongue indentations (P 0.00), with multiple symptoms of the condition.
Conclusion:
Multiple TMD symptoms were prevalent among individuals with elevated stress, abnormal sleep pattern, traumatic dental treatment, elevated HAD scale. The results highlighted the importance of psychological factors in the pathogenesis of TMD.
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YILMAZ B, SOMAY E. Temporomandibular eklem bozukluğu tanısının manyetik rezonans görüntüleme ile doğrulanması. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.687196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Smith JG, Karamat A, Melek LN, Jayakumar S, Renton T. The differential impact of neuropathic, musculoskeletal and neurovascular orofacial pain on psychosocial function. J Oral Pathol Med 2020; 49:538-546. [PMID: 32531812 DOI: 10.1111/jop.13071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND While the psychosocial morbidity of orofacial pain (OFP) is widely recognized, the differential impact of musculoskeletal, neuropathic and neurovascular symptoms on pain and psychosocial function in individuals with and without coexisting OFP conditions is unclear. MATERIALS AND METHODS This was a comparative cross-sectional study of 350 consecutive patients attending an OFP clinic; 244 completed standardized self-report measures of pain experience, mood, and generic and oral health-related quality of life (HRQoL). The impact of musculoskeletal, neuropathic and neurovascular symptoms on measures was assessed using linear and logistic generalized linear models. RESULTS Two hundred patients were diagnosed with a neuropathic condition: 125 with musculoskeletal pain and 101 with (neurovascular) headache disorders. 23% of patients presented with multiple OFP conditions; this was more common in patients with neurovascular (62%) than neuropathic (21%) and/or musculoskeletal orofacial symptoms (28%). Patients with neurovascular symptoms experienced significantly higher levels of pain, evidenced less pain self-efficacy and had poorer overall health. Neuropathic OFP was significantly associated with greater psychological and social oral health disability. Multiple OFP symptoms were not linked to pain severity or psychosocial function, although health scores were worse for patients with neurovascular pain and neuropathic/musculoskeletal symptoms compared with patients with only neurovascular symptoms. CONCLUSIONS The profile and degree of psychosocial morbidity in patients with OFP is significantly related to the types of presenting orofacial symptoms. Patients with neurovascular pain present with higher pain levels and have poorer health while those with neuropathic pain have higher oral functional morbidity; both may require more complex multidisciplinary management.
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Affiliation(s)
- Jared G Smith
- Population Health Research Institute, St George's, University of London, London, UK
| | - Aalia Karamat
- Department of Oral Surgery, King's College London Dental Institute, London, UK
| | - Lydia N Melek
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Simone Jayakumar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tara Renton
- Department of Oral Surgery, King's College London Dental Institute, London, UK
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Incident injury is strongly associated with subsequent incident temporomandibular disorder: results from the OPPERA study. Pain 2020; 160:1551-1561. [PMID: 30883525 DOI: 10.1097/j.pain.0000000000001554] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Cross-sectional studies confirm, as expected, a positive association between jaw injury and painful temporomandibular disorders (TMDs), but prospective evaluations are lacking. We prospectively assessed incident jaw injury, injury type, and development of TMD in adults aged 18 to 44 years. Data were collected from 3258 individuals from communities surrounding 4 US academic institutes between 2006 and 2008. At enrollment, participants reported no TMD history and no facial injuries in the previous 6 months. Quarterly, follow-up questionnaires assessed incident jaw injury, which was classified as intrinsic (attributed to yawning or prolonged mouth opening) or extrinsic (attributed to other causes). Examiners classified incident TMD during a median follow-up period of 2.8 years (range 0.2-5.2 years). Cox regression models used jaw injury as a time-dependent covariate to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association with incident TMD. Among 1729 participants with complete data, 175 developed TMD. Eighty percent of injuries were intrinsic. Temporomandibular disorder annual incidence was nearly twice as high in those experiencing jaw injury (5.37%) compared with those who did not (3.44%). In the Cox model that accounted for timing of injury, the corresponding HR was 3.94 (95% CI = 2.82-5.50) after adjusting for study site, age, race, and sex. Hazard ratios did not differ (P = 0.91) for extrinsic injuries (HR = 4.03, 95% CI = 2.00-8.12) and intrinsic injuries (HR = 3.85, 95% CI = 2.70-5.49). Jaw injury was strongly associated with incident TMD. If surveillance and intervention after jaw injury is to be effective in preventing TMD, they should focus on both intrinsic and extrinsic injuries.
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Yamaner FE, Celakil T, Gökcen Roehlig B. Comparison of the efficiency of two alternative therapies for the management of temporomandibular disorders. Cranio 2020; 40:189-198. [DOI: 10.1080/08869634.2020.1727667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Tamer Celakil
- Department of Prosthodontics, Istanbul University, Istanbul, Turkey
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Resende CMBMD, Rocha LGDDS, Paiva RPD, Cavalcanti CDS, Almeida EOD, Roncalli AG, Barbosa GAS. Relationship between anxiety, quality of life, and sociodemographic characteristics and temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:125-132. [DOI: 10.1016/j.oooo.2019.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/06/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022]
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Riley P, Glenny AM, Worthington HV, Jacobsen E, Robertson C, Durham J, Davies S, Petersen H, Boyers D. Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation. Health Technol Assess 2020; 24:1-224. [PMID: 32065109 PMCID: PMC7049908 DOI: 10.3310/hta24070] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Splints are a non-invasive, reversible management option for temporomandibular disorders or bruxism. The clinical effectiveness and cost-effectiveness of splints remain uncertain. OBJECTIVES The objectives were to evaluate the clinical effectiveness and cost-effectiveness of splints for patients with temporomandibular disorders or bruxism. This evidence synthesis compared (1) all types of splint versus no/minimal treatment/control splints and (2) prefabricated versus custom-made splints, for the primary outcomes, which were pain (temporomandibular disorders) and tooth wear (bruxism). REVIEW METHODS Four databases, including MEDLINE and EMBASE, were searched from inception until 1 October 2018 for randomised clinical trials. The searches were conducted on 1 October 2018. Cochrane review methods (including risk of bias) were used for the systematic review. Standardised mean differences were pooled for the primary outcome of pain, using random-effects models in temporomandibular disorder patients. A Markov cohort, state-transition model, populated using current pain and Characteristic Pain Intensity data, was used to estimate the incremental cost-effectiveness ratio for splints compared with no splint, from an NHS perspective over a lifetime horizon. A value-of-information analysis identified future research priorities. RESULTS Fifty-two trials were included in the systematic review. The evidence identified was of very low quality with unclear reporting by temporomandibular disorder subtype. When all subtypes were pooled into one global temporomandibular disorder group, there was no evidence that splints reduced pain [standardised mean difference (at up to 3 months) -0.18, 95% confidence interval -0.42 to 0.06; substantial heterogeneity] when compared with no splints or a minimal intervention. There was no evidence that other outcomes, including temporomandibular joint noises, decreased mouth-opening, and quality of life, improved when using splints. Adverse events were generally not reported, but seemed infrequent when reported. The most plausible base-case incremental cost-effectiveness ratio was uncertain and driven by the lack of clinical effectiveness evidence. The cost-effectiveness acceptability curve showed splints becoming more cost-effective at a willingness-to-pay threshold of ≈£6000, but the probability never exceeded 60% at higher levels of willingness to pay. Results were sensitive to longer-term extrapolation assumptions. A value-of-information analysis indicated that further research is required. There were no studies measuring tooth wear in patients with bruxism. One small study looked at pain and found a reduction in the splint group [mean difference (0-10 scale) -2.01, 95% CI -1.40 to -2.62; very low-quality evidence]. As there was no evidence of a difference between splints and no splints, the second objective became irrelevant. LIMITATIONS There was a large variation in the diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these limitations did not indicate a reduction in pain. CONCLUSIONS The very low-quality evidence identified did not demonstrate that splints reduced pain in temporomandibular disorders as a group of conditions. There is insufficient evidence to determine whether or not splints reduce tooth wear in patients with bruxism. There remains substantial uncertainty surrounding the most plausible incremental cost-effectiveness ratio. FUTURE WORK There is a need for well-conducted trials to determine the clinical effectiveness and cost-effectiveness of splints in patients with carefully diagnosed and subtyped temporomandibular disorders, and patients with bruxism, using agreed measures of pain and tooth wear. STUDY REGISTRATION This study is registered as PROSPERO CRD42017068512. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 7. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Anne-Marie Glenny
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Elisabet Jacobsen
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Clare Robertson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Justin Durham
- Centre for Oral Health Research and School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Stephen Davies
- TMD Unit, University Dental Hospital of Manchester, Manchester, UK
| | - Helen Petersen
- University Dental Hospital of Manchester, Manchester, UK
| | - Dwayne Boyers
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
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Banafa A, Suominen AL, Sipilä K. Factors associated with signs of temporomandibular pain: an 11-year-follow-up study on Finnish adults. Acta Odontol Scand 2020; 78:57-63. [PMID: 31401930 DOI: 10.1080/00016357.2019.1650955] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Pain in the temporomandibular region is a main complaint causing disability and distress among temporomandibular disorders sufferers.Objectives: The aim of the study was, over an 11-year follow-up on Finnish adult population, to investigate the prevalence of clinically assessed pain-related temporomandibular disorder (TMD) signs, i.e. temporomandibular joint (TMJ) and masticatory muscles (MM) pain on palpation, and their association with sociodemographic background and denture status.Methods: The data were based on the nationally representative Finnish Health 2000 and Health 2011 Surveys (BRIF8901). The sample comprised 1210 adults who underwent clinical oral examinations including TMD signs assessment. Statistical evaluations included chi-square tests and logistic regressions.Results: The prevalence of palpatory MM pain decreased from 9.5% at baseline to 4.6% in the follow-up. Cross-sectionally, presence of palpatory MM pain significantly associated with gender (p < .001, p = .002) and educational level (p < .001, p = .001) in both years, and with age (p = .006) and denture status (p = .022) at baseline. The prevalence of palpatory TMJ pain increased from 2.1% at baseline to 3.5% in the follow-up. Presence of palpatory TMJ pain significantly associated with gender in both years (p = .012, p = .032). Female gender, lower education and palpatory MM pain at baseline predicted palpatory MM pain in the follow-up.Conclusion: Palpatory MM pain is relatively prevalent in adults, yet with a favourable prognosis. Women and people with low education are more susceptible groups. Previous experience of palpatory MM pain increases the risk of exhibiting it later in life.
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Affiliation(s)
- Aisha Banafa
- Faculty of Health Sciences, School of Medicine, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Public Health Evaluation and Projection Unit, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Kirsi Sipilä
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
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Lee KC, Wu YT, Chien WC, Chung CH, Chen LC, Shieh YS. The prevalence of first-onset temporomandibular disorder in low back pain and associated risk factors: A nationwide population-based cohort study with a 15-year follow-up. Medicine (Baltimore) 2020; 99:e18686. [PMID: 32011444 PMCID: PMC7220485 DOI: 10.1097/md.0000000000018686] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The coexistence of low back pain (LBP) and temporomandibular disorder (TMD) has often been noted clinically. However, studies of the association between these two conditions involving a large population with longitudinal evidences are lacking. Therefore, the study aimed to investigate the association between LBP and TMD in a nationwide-matched cohort population with a 15-year follow-up.Data of 65,121 patients newly diagnosed with LBP were analyzed, along with those of 195,363 (1:3) sex- and age-matched controls. Multivariate Cox regression analysis was used to determine TMD risk between the LBP and non-LBP groups. Kaplan-Meier method was used for determining the cumulative risk of first-onset TMD between groups, with a 15-year follow-up.The LBP group was more likely to develop first-onset TMD (adjusted hazards ratio (HR) = 1.561, P < .001), after adjusting for demographic variables and comorbidities. The risk factors for TMD were LBP, young age, higher insured premium, and osteoporosis. In the subgroup analysis, the LBP group had a higher risk of TMD than the non-LBP group in all stratifications.LBP is the risk factor contributing to the development of first-onset TMD. Therefore, clinicians should be reminded to manage LBP disorders concurrently when treating TMD.
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Affiliation(s)
- Kuei-Chen Lee
- Graduate Institute of Medical Sciences
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital
| | - Yung-Tsan Wu
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital
| | - Wu-Chien Chien
- School of Public Health
- Department of Medical Research, Tri-Service General Hospital
- Graduate Institute of Life Science
| | - Chi-Hsiang Chung
- School of Public Health
- Department of Medical Research, Tri-Service General Hospital
| | - Liang-Cheng Chen
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital
| | - Yi-Shing Shieh
- Graduate Institute of Medical Sciences
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Updates in the Approach to Chronic Pelvic Pain: What the Treating Gynecologist Should Know. Clin Obstet Gynecol 2019; 62:666-676. [DOI: 10.1097/grf.0000000000000486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Buscemi V, Chang WJ, Liston MB, McAuley JH, Schabrun SM. The Role of Perceived Stress and Life Stressors in the Development of Chronic Musculoskeletal Pain Disorders: A Systematic Review. THE JOURNAL OF PAIN 2019; 20:1127-1139. [DOI: 10.1016/j.jpain.2019.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/29/2019] [Accepted: 02/16/2019] [Indexed: 02/07/2023]
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Awal D, Amin K, Venda-Nova C, Naqvi A, Zakrzewska J. The specialist management of non-temporomandibular orofacial pain: maxillofacial surgery’s known unknown? Br J Oral Maxillofac Surg 2019; 57:749-754. [DOI: 10.1016/j.bjoms.2019.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 06/21/2019] [Indexed: 11/26/2022]
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Mingels S, Dankaerts W, Granitzer M. Preclinical Signs of a Temporomandibular Disorder in Female Patients With Episodic Cervicogenic Headache Versus Asymptomatic Controls: A Cross-Sectional Study. PM R 2019; 11:1287-1295. [PMID: 30859716 DOI: 10.1002/pmrj.12156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/03/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The International Classification of Headache Disorders, 3rd Edition, accepted "headache attributed to temporomandibular disorders" as a valid headache. The neurophysiologic interplay between cervical structures and the temporomandibular joint, however, might also suggest that a temporomandibular disorder could develop in patients with cervicogenic headache. OBJECTIVE To compare the presence of preclinical temporomandibular signs between female patients with episodic cervicogenic headache and a control group. DESIGN Case-controlled cross-sectional design. SETTING Institutional setting: Hasselt University. PARTICIPANTS Twenty-two women (mean age ± SD: 20.7 ± 2.5 years) with episodic cervicogenic headache, without temporomandibular signs and 22 matched (gender, age, level of education, occupation) asymptomatic controls (21 ± 2.3 years). METHODS (Un)assisted temporomandibular range of motion, pressure pain thresholds, painful palpations were examined and the level of perceived stress was measured. MAIN OUTCOME MEASUREMENTS Temporomandibular range of motion (mm), pressure pain thresholds (kPa/cm²), painful palpations (yes/no), and level of perceived stress (Perceived Stress Scale). RESULTS Maximal mouth-opening was significantly smaller in the headache group (P <.05; effect size [ES] -0.45). Palpation of the masseter resulted in significantly more positive pain responses in the headache group at the left (P = .009; ES ∞) and right (P = .002;ES 17.5) origin, left (P = .004; ES 14.54) and right (P = .03; ES 5.71) body and left (P < .001; ES 12) insertion. Significantly lower pressure pain thresholds on the left and right anterior (P = .03; ES -0.33 resp. P = .02; ES -0.35), central (P = .003; ES 1.02 resp. P = .02; ES 0.79) and right posterior (P = .03; ES 0.62) temporalis and right tibialis anterior (P = .03; ES -0.33) were measured in the headache group. The level of perceived stress was significantly higher (P = .02) in the headache group. CONCLUSIONS Patients with episodic cervicogenic headache present with signs of a preclinical temporomandibular disorder and sensitization. The smaller range of motion, lower pressure pain thresholds, and higher levels of stress accentuate the multidimensionality of the problem. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Sarah Mingels
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.,Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium
| | - Wim Dankaerts
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium
| | - Marita Granitzer
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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Penlington C, Araújo-Soares V, Durham J. Predicting Persistent Orofacial Pain: The Role of Illness Perceptions, Anxiety, and Depression. JDR Clin Trans Res 2019; 5:40-49. [PMID: 31063437 DOI: 10.1177/2380084419846447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Persistent orofacial pain (POFP) can be caused by a range of conditions affecting the mouth and face and is often associated with significant disability. Biopsychosocial factors are known to be important predictors and have not yet been fully explored in this population. OBJECTIVES This study aimed to explore whether illness perceptions and psychological distress (anxiety and depression) could predict long-term outcome in a community-based sample of patients receiving routine care for POFP. METHODS A longitudinal cohort design study assessed 198 patients recruited from primary or secondary health care settings on 5 separate occasions over a 2-y period. Outcome was measured by the Graded Chronic Pain Scale and dichotomized into good or poor outcome categories. Independent variables included subscale scores of the psychometrically shortened Illness Perception Questionnaire and the Patient Health Questionnaire-4 (PHQ-4, assessing anxiety and depressive symptomatology). Logistic regressions were performed to test whether scores on each subscale would be associated with different outcomes for patients at 12 and 24 mo and overall. RESULTS Beliefs about consequences predicted outcome category (good vs. poor) above and beyond other illness perception subscales, anxiety, and depressive symptomatology (z = 3.78; P < 0.000; odds ratio [OR], 3.05; 95% confidence interval [CI], 1.71-5.43). Both depressive symptomatology, measured by the PHQ-2 (P = 0.001; OR, 4.06; 95% CI, 1.74-9.52), and psychological distress (mixed anxiety and depression; P = 0.029; OR, 2.88; 95% CI, 1.12-7.41), measured by the PHQ-4, were also predictive of poor outcome, but these effects were no longer significant once measures of illness perceptions were added. CONCLUSION Beliefs about the consequences of POFP are important predictors of outcome independent of other variables and can easily and briefly be included in assessments to inform management decisions. KNOWLEDGE TRANSFER STATEMENT The results of this study are relevant because they will allow clinicians to consider the use of brief and easy-to-administer self-report measures to identify POFP patients at higher risk of poor outcome so that management can be planned accordingly.
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Affiliation(s)
- C Penlington
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Newcastle, UK.,Newcastle upon Tyne Hospitals' NHS Foundation Trust, Newcastle upon Tyne, UK
| | - V Araújo-Soares
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - J Durham
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Newcastle, UK.,Newcastle upon Tyne Hospitals' NHS Foundation Trust, Newcastle upon Tyne, UK
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Long-term changes in biopsychosocial characteristics related to temporomandibular disorder: findings from the OPPERA study. Pain 2019; 159:2403-2413. [PMID: 30028791 DOI: 10.1097/j.pain.0000000000001348] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Painful temporomandibular disorders (TMDs) are both consequence and cause of change in multiple clinical, psychosocial, and biological factors. Although longitudinal studies have identified antecedent biopsychosocial factors that increase risk of the TMD onset and persistence, little is known about long-term change in those factors after TMD develops or remits. During a 7.6-year median follow-up period, we measured change in psychosocial characteristics, pain sensitivity, cardiovascular indicators of autonomic function, and clinical jaw function among 189 participants whose baseline chronic TMD status either persisted or remitted and 505 initially TMD-free participants, 83 of whom developed TMD. Among initially TMD-free participants who developed TMD, symptoms and pain sensitivity increased, whereas psychological function worsened. By contrast, participants with chronic TMD at baseline tended to show improved TMD symptoms, improved jaw function, reduced somatic symptoms, and increased positive affect. In general, clinical and psychosocial variables more frequently changed in parallel with TMD status compared with pain sensitivity and autonomic measures. These findings demonstrate a complex pattern of considerable changes in biopsychosocial function associated with changes in TMD status. In particular, several biopsychosocial parameters improved among participants with chronic TMD despite pain persisting for years, suggesting considerable potential for ongoing coping and adaptation in response to persistent pain.
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Clauw DJ, Essex MN, Pitman V, Jones KD. Reframing chronic pain as a disease, not a symptom: rationale and implications for pain management. Postgrad Med 2019; 131:185-198. [DOI: 10.1080/00325481.2019.1574403] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Daniel J. Clauw
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | | | - Verne Pitman
- Global Medical Affairs, US Medical Affairs, Pfizer Inc, New York, NY, USA
| | - Kim D. Jones
- School of Nursing, Linfield College, Portland, OR, USA
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46
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Velly AM, Mohit S. Epidemiology of pain and relation to psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87:159-167. [PMID: 28522289 DOI: 10.1016/j.pnpbp.2017.05.012] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/10/2017] [Accepted: 05/14/2017] [Indexed: 12/11/2022]
Abstract
Chronic pain is a common pain condition. Some psychiatric disorders, such as anxiety and depression, are also common in the general population. Epidemiological studies found that some psychiatric disorders are more commonly found among persons with chronic pain (e.g., headache, back pain) than those without chronic pain. Why those psychiatric disorders co-occur with chronic pain, however, is not well understood. Further, studies demonstrated that some psychiatric disorders, such as depression, increase the risk of chronic pain as well as its persistence. It is also recognized that chronic pain has a negative impact on the persistence of psychiatric disorders. The observations from clinical studies suggest that chronic pain is not a common comorbidity among individuals with other psychiatric disorders, such as dementia and schizophrenia. It is not clear if this is a consequence of any specific biological mechanism, or methodology problems in the studies. This paper provides an overview on the distribution of chronic pain and psychiatric disorders, followed by a review of studies that have demonstrated the association between psychiatric disorders and chronic pain.
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Affiliation(s)
- Ana Miriam Velly
- Faculty of Dentistry, McGill University, Montreal, Canada; Centre for Clinical Epidemiology, Canada; Department of Dentistry, Jewish General Hospital, 3755, Chemin de la Côte Ste-Catherine, Suite A-017, H3T 1E2 Montréal, Québec, Canada.
| | - Shrisha Mohit
- Department of Dentistry, Jewish General Hospital, 3755, Chemin de la Côte Ste-Catherine, Suite A-017, H3T 1E2 Montréal, Québec, Canada.
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Abstract
This article summarizes the cognitive, behavioral, and emotional factors that contribute to the onset and maintenance of orofacial pain. These orofacial pain conditions illustrate the dynamic interplay of the mind and body and the importance of multimodal treatment approaches addressing simultaneously the cognitive, behavioral, and physiologic dimensions of facial pain. Cognitive and behavioral treatments of temporomandibular disorders based on the outcomes of randomized controlled trials are also discussed with an emphasis on using a biopsychosocial perspective when working with the persons who have temporomandibular disorders.
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Affiliation(s)
- Hayley A Cole
- Department of Psychology, University of Kentucky, 111 Kastle Hall, Lexington, KY 40506, USA
| | - Charles R Carlson
- Department of Psychology, Orofacial Pain Clinic, University of Kentucky, 209-A Kastle Hall, Lexington, KY 40506, USA.
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Kapos FP, Look JO, Zhang L, Hodges JS, Schiffman EL. Predictors of Long-Term Temporomandibular Disorder Pain Intensity: An 8-Year Cohort Study. J Oral Facial Pain Headache 2018; 32:113-122. [PMID: 29694463 PMCID: PMC6443255 DOI: 10.11607/ofph.1819] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIMS To investigate, in individuals with pain-related temporomandibular disorder (TMD), the association of long-term pain intensity with baseline health-related quality of life (HRQoL) and jaw functional limitation. METHODS Of 513 cases with baseline pain-related TMD (masticatory muscle and/or temporomandibular joint [TMJ] pain), 273 were reevaluated after 8 years, and 258 of them had complete baseline data for Jaw Functional Limitation Scale (JFLS) scores and HRQoL measured by the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the 12-item Short Form Health Survey and follow-up data for Characteristic Pain Intensity (CPI) from the Graded Chronic Pain Scale. Secondary analyses of existing data quantified the effects of primary (PCS, MCS) and secondary (JFLS) predictors on follow-up CPI by using multivariable linear regression. Sensitivity analyses considered differences between the included participants (n = 258) and those who were not included (n = 255) by using inverse probability weighting. Interactions of baseline predictors with age, sex, and baseline CPI were evaluated using multivariable linear regression. RESULTS The score for baseline PCS, but not MCS or JFLS, was associated with follow-up CPI (P = .012). One standard deviation (SD = 9.0)-higher baseline PCS score predicted an overall 3.2-point-lower follow-up CPI (95% confidence interval -5.8 to -0.7) after adjusting for age, sex, MCS, JFLS, and baseline CPI scores. However, the effect of PCS score was not uniform: the association between PCS and follow-up CPI scores was statistically significant for participants with baseline CPI ≥ 51.3/100 and clinically significant for participants with baseline CPI ≥ 68.7/100. Adjustment for TMD treatments and sensitivity analyses had negligible effect. CONCLUSION In participants with moderate to severe baseline TMD pain intensity, higher baseline physical HRQoL predicted lower TMD pain intensity at 8 years follow-up. PCS score could contribute to a multifactorial long-term TMD pain prediction model.
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Affiliation(s)
- Flavia P. Kapos
- Department of Oral Health Sciences, School of Dentistry, University of Washington
- PhD Student, Department of Epidemiology, School of Public Health, University of Washington, 1959 NE Pacific St, Box 357475, Seattle, WA 98195, (206) 685-5059,
| | - John O. Look
- Division of TMD and Orofacial Pain, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware St SE, 6-320 Moos Tower, Minneapolis, MN 55455
| | - Lei Zhang
- Biostatistical Design and Analysis Center (BDAC), Clinical and Translational Science Institute, University of Minnesota, 717 Delaware Street SE, Second Floor, Minneapolis, MN 55414
| | - James S. Hodges
- Division of Biostatistics, School of Public Health, University of Minnesota, 2221 University Ave SE, Suite 200, Minneapolis, MN 55414
| | - Eric L. Schiffman
- Division of TMD and Orofacial Pain, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware St SE, 6-320 Moos Tower, Minneapolis, MN 55455
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Breckons M, Shen J, Bunga J, Vale L, Durham J. DEEP Study: Indirect and Out-of-pocket Costs of Persistent Orofacial Pain. J Dent Res 2018; 97:1200-1206. [DOI: 10.1177/0022034518773310] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Persistent orofacial pain (POFP) is common and caused by a group of conditions affecting the face, head, or mouth. Recent research highlighted a problematic care pathway with high costs to the health care provider, but the financial impact on patients and employers is not understood. This study aimed to describe patient (out-of-pocket) and employer (indirect) costs of POFP and to identify whether the dichotomized Graded Chronic Pain Scale (GCPS) was predictive of costs. A cohort of 198 patients was recruited from primary and secondary care settings in North East England and followed over a 24-mo period. Patients completed the GCPS and Use of Services and Productivity Questionnaire every 6 mo and a Time and Travel Questionnaire at 14 mo. Questionnaires examined the implications of health care utilization on patients’ everyday lives and personal finances. Time and travel costs were calculated and applied to use-of-services data to estimate out-of-pocket costs, while the human capital method and QQ method (quantity and quality of work completed) were used to estimate absenteeism and presenteeism costs, respectively. Per person per 6-mo period (in 2017 pounds sterling), mean out-of-pocket costs were £333 (95% CI, £289 to £377), and indirect costs were £1,242 (95% CI, £1,014 to £1,470). Regression analyses indicated that over 6 mo, the GCPS was predictive of the following: out-of-pocket costs—a difference of £311 between low and high GCPS per person per 6-mo period (95% CI, £280 to £342; P < 0.01, n = 705 observations over 24 mo); indirect costs—a difference of £2,312 between low and high GCPS per person per 6-mo period (95% CI, £1,886 to £2,737; P < 0.01; n = 352 observations over 24 mo). This analysis highlights “hidden” costs of POFP and supports the use of the dichotomized GCPS to identify patients at risk of higher impact and associated costs and thereby stratify care pathways and occupational health support appropriately.
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Affiliation(s)
- M. Breckons
- Health Economics Group, Institute of Health and Society, Newcastle upon Tyne, UK
| | - J. Shen
- Health Economics Group, Institute of Health and Society, Newcastle upon Tyne, UK
| | - J. Bunga
- Health Economics Group, Institute of Health and Society, Newcastle upon Tyne, UK
| | - L. Vale
- Health Economics Group, Institute of Health and Society, Newcastle upon Tyne, UK
| | - J. Durham
- Health Economics Group, Institute of Health and Society, Newcastle upon Tyne, UK
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Upon Tyne Hospitals’ NHS Foundation Trust, Newcastle upon Tyne, UK
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50
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Fond G, Boyer L, Andrianarisoa M, Godin O, Bulzacka E, Berna F, Brunel L, Coulon N, Aouizerate B, Capdevielle D, Chereau I, D'amato T, Denizot H, Dubertret C, Dubreucq J, Faget C, Leignier S, Mallet J, Misdrahi D, Rey R, Lancon C, Passerieux C, Schandrin A, Urbach M, Vidailhet P, Leboyer M, Schurhoff F, Llorca PM. Self-reported pain in patients with schizophrenia. Results from the national first-step FACE-SZ cohort. Prog Neuropsychopharmacol Biol Psychiatry 2018; 85:62-68. [PMID: 29678770 DOI: 10.1016/j.pnpbp.2018.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/11/2018] [Accepted: 04/15/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Little is known about perception of physical pain in schizophrenia (SZ). Some studies have suggested that patients with SZ may have an increased pain threshold, while others have suggested that patients with SZ may suffer from undetected and untreated high physical pain levels. The objectives of this study were (i) to investigate the prevalence of self-reported physical pain in stabilized SZ subjects, and (ii) to determine whether physical pain was associated with psychiatric characteristics and somatic comorbidities (iii) to determine whether antidepressants and benzodiazepine administration were associated with lower self-reported pain. METHOD 468 community-dwelling stable SZ subjects (73% men, mean aged 32 years) were recruited in the Schizophrenia Expert Center national network. Patients with moderate to extreme pain, assessed with the EQ5D-5L questionnaire, were classified as belonging to the "pain group". RESULTS 104 (22.2%) reported moderate to extreme pain levels. In multivariate analysis, pain has been associated with headache (OR = 2.63 [1.04-6.63], p = 0.04), higher anxiety (OR = 1.61 [1.18-2.21], p = 0.003), higher current depressive symptoms (OR = 1.09 [1.01-1.17], p = 0.03), history of childhood trauma (1.03 [1.01-1.06], p = 0.01) and older age (OR = 1.04 [1.01-1.07], p = 0.03), independently of current psychotic severity, sociodemographic variables, antipsychotic, antidepressant and benzodiazepine treatments. No association with addictive behaviors or illness characteristics has been found. CONCLUSION The present findings suggest that community-dwelling SZ outpatients report a high rate of self-reported physical pain, associated with headache, depression and anxiety and history of childhood trauma. Physical pain should be systematically assessed and specifically treated, when needed, in patients with SZ.
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Affiliation(s)
- Guillaume Fond
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, School of MEDICINE - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France.
| | - Laurent Boyer
- Fondation FondaMental, Créteil, France; Aix-Marseille Univ, School of MEDICINE - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Meja Andrianarisoa
- Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry Team, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Ophelia Godin
- Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France; INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, F-75013 Paris, France
| | - Ewa Bulzacka
- Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry Team, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Fabrice Berna
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Lore Brunel
- Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry Team, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Nathalie Coulon
- Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry Team, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, 1061, Montpellier, France
| | - Isabelle Chereau
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - Thierry D'amato
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est, BP 300 39-95 bd Pinel, 69678 Bron Cedex, France
| | - Hélène Denizot
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - Julien Dubreucq
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Catherine Faget
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Sylvain Leignier
- Fondation FondaMental, Créteil, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France; Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France; CNRS UMR 5287-INCIA, France
| | - Romain Rey
- Fondation FondaMental, Créteil, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est, BP 300 39-95 bd Pinel, 69678 Bron Cedex, France
| | - Christophe Lancon
- Fondation FondaMental, Créteil, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Aurélie Schandrin
- Fondation FondaMental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, 1061, Montpellier, France
| | - Mathieu Urbach
- Fondation FondaMental, Créteil, France; Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Pierre Vidailhet
- Fondation FondaMental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry Team, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Franck Schurhoff
- Fondation FondaMental, Créteil, France; INSERM U955, Translational Psychiatry Team, Créteil, France; Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Créteil, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
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