Mood Spectrum in Patients with Different Painful Temporomandibular Disorders

Abstract

The purpose of this study was to investigate for difference in the prevalence of mood disorders between patients with different painful temporomandibular disorders (TMD). After a sample size necessary for the study was calculated, 60 patients with a painful TMD were selected and divided into the following groups: myofascial pain (n=20), temporomandibular joint (TMJ) pain (n=18), combined myofascial and TMJ pain (n=22). Two distinct comparison groups were selected: subjects with a nonpainful TMD (n=25) and TMD-free subjects (n=29). All participants filled out a self-report validated instrument (MOODS-SR) to evaluate psychopathological symptoms related to mood disturbances. A one-way analysis of variance (ANOVA) with Bonferroni's post hoc test for multiple comparisons was performed to investigate for significant differences among the groups. The three groups of patients with painful TMD scored significantly higher than comparison groups in all MOODS-SR domains investigating depression, but no difference was shown between subjects with myofascial pain and those with TMJ pain. No significant differences among the groups emerged for the presence of manic symptoms, indicating that depressive disorders associated with TMD are not an expression of a more complex manic depressive illness. The study concluded that the presence of depressive symptoms in TMD patients seems to be related to the presence of a painful condition and seems to be unrelated to the location of pain. Furthermore, depressive disturbances in painful TMD patients affect the whole spectrum of depressive psychopathology.

Temporomandibular joint total replacement prosthesis: current knowledge and considerations for the future

“…It may be that individual psychosocial factors play an important role in patient perception of treatment efficacy in the surgical approach to the TMJ, and that psychosocial impairment is more disabling in those patients with a history of many failed previous surgeries. This aspect has not been assessed in the available literature, which represents a limitation to the generalization of findings to date, and becomes even more important if one considers the number of works demonstrating the influence of psychosocial factors in the onset of TMD symptoms and their treatment outcome 11,14,21,22,53,62,71,72 . It is also likely that neurophysiological aspects of chronic centrally mediated pain are at the basis of the poorer subjective response of multiply operated patients.…”

“…The most common age of onset is 20-40 years, and signs and symptoms tend to decrease with age 10,19 . Literature data suggest that TMD-related pain has a relevant psychosocial impact as well 14,21,22,62,72 . Many conservative approaches to the treatment of both articular and muscular TMD have been proposed over the years, including occlusal splint therapy 4,63 , physiotherapy 42,43 , complimentary medicine 5,12 , pharmacotherapy 7,24 and occlusal treatments 18 .…”

Mood disorders in subjects with bruxing behavior

“…Data about the estimated variance were drawn from other works in the literature. [24][25][26] The difference to detect has been identified in a 40% difference between groups in mean MOODS-SR scores, which can be considered clinically relevant. 27 In consideration of that, to have a 90% statistical power to detect a 40% difference between groups, the needed sample size was about 35 subjects per group.…”

Isolated Non-Traumatic Bilateral Coronoid Process Fracture of the Mandible

“…This patient has a history of depression and mood disorder symptoms for which she was previously on treatment with Zoloft. Although it has been studied that mood disorders are associated with chronic TMJ pain, no association with coronoid process fractures has been reported [10]. …”