Psychological Distress and Pain Among TMD Sufferers

Temporomandibular Disorders(TMD) are a major cause of non-dental pain in the orofacial region. Its association with psychological distress have been implicated. Objective: To determine the association of TMD pain with psychological distress among TMD sufferers in an urban population in Malaysia. Method: A total of 155 patients were selected for this study. All the patients were referred to the TMD clinic, Dental Faculty, University of Malaysia for attention of their TMD symptoms. Using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) sociodemographic factors, duration of pain, Depression and Non-Specific Physical Symptom (NSPs) scores were charted. The association between Depression and NSPS scores/scales with duration and Characteristic Pain Intensity (CPI) of TMD pain were compared, using ANOVA and Chi-square test respectively. Results: Out of 155 patients, 33.6% were males and 66.4% were females. The ratio of Malays : Chinese : Indians was 1.5 : 2.4 : 1. As many as 25.5%, 22.0% and 17.4% of TMD patients had moderate-to-severe scales of Depression and NSPS [with pain items included (NSPS-P) and without pain items included (NSPS-NP)] respectively. The Depression Scale was significantly different among patients who endured pain duration of one year or less (LOY) as compared to those with pain of more than one year's duration (MOY) (p=0.007). The NSP-P was also significantly different between those with pain of LOY and MOY (p=0.02). When pain items were excluded the difference in NSPS-NP scales were still significant (p=0.03). Regression analyses showed that patients with pain duration of MOY had a higher risk of having severe psychological distress (p = 0.010). The CPI of the patients were also highly correlated to their scores of depression and NSPS. Conclusion: Psychological distress is prevalent among TMD sufferers and the severity is associated with the duration and characteristic pain intensity. This study is part of a PhD research.