Depression: a Risk Factor for Progression of TMD Chronic Pain Grade

Depression has been considered to be a potential contributing factor to progression of non-chronic temporomandibular disorders (TMD). Objective: A prospective observational study is underway to study progression from non-chronic to chronic pain status in a TMD population recruited from the Minneapolis/St. Paul area through advertisements and notices sent to local dentists. Methods: Admission to this study required a diagnosis of TMD and a pain frequency at least once per week. Baseline examinations have been completed on 600 subjects, with a mean age of 35.8 years + 12.5(SD); 88.9% are females. The 18 and 36-month follow-up examinations have been completed for 512 and 364 subjects respectively. The Beck Depression Inventory© (BDI) was completed by subjects at baseline (range 0 -63). Chronic Pain Grade (CPG) status was determined using methods of grading chronic pain severity identified by Von Korff, et al. (1992). Progression in CPG status was defined as an increase in CPG score at follow-up examinations. Results: Baseline BDI scores were significantly associated with progression in CPG at 18 months, in both the unadjusted analysis (p=0.0403), as well as when adjusted to control for gender and age (p=0.0427). Baseline BDI scores were not associated with progression in CPG at 36 months in the unadjusted analysis (p=0.0828), nor in the adjusted analysis (p=0.2006). Conclusion: This study indicates that the BDI score at baseline in TMD subjects was associated with progression in chronic pain grade at 18, but not at 36 months. This study was funded by NIH/NIDCR grants # RO1DE11252 and # DE09737-09.