Salivary cortisol and psychological factors in women with chronic and acute oro‐facial pain

Abstract

The aim of this study was to compare the salivary cortisol level, pain intensity and psychological factors between patients with chronic and acute oro-facial pain (OP) and pain-free subjects. Twenty-seven females with chronic OP (a diagnosis of myofascial pain according to the Research Diagnostic Criteria for Temporomandibular Disorders with at least 6 months duration), 24 females with acute OP (<10 days duration) and 27 pain-free females participated. Morning saliva was collected from all participants for analyses of the cortisol level. The pain intensity was assessed on a 0-10 numeric rating scale. The participants were evaluated by the Symptom Checklist 90-revised for levels of depression and somatisation, and the Perceived Stress Scale. The cortisol levels among the three patient groups were similar with no significant group differences. The median (interquartile range) current pain level did not differ between chronic and acute OP and was, respectively, 5 (4) and 5 (3). Patients with chronic OP showed significantly higher scores for depression, somatisation and perceived stress compared with patients with acute OP (Ps < 0.001), but there were no significant differences between acute OP and controls. To conclude, there were no differences in cortisol level between groups, despite significant higher levels of depression, somatisation and perceived stress in patients with chronic OP. This shows that psychological distress has a more important role in chronic than in acute OP. However, the relation between pain, adreno-cortical activity and psychological distress is complex and warrants further investigation.

Salivary cortisol responses to acute stress in students with myofascial pain

“…Jasim et al [32] reported that patients with chronic MFP show significantly higher scores of depression symptoms, somatization and perceived stress compared to patients with acute pain. In the current study, the differences in anxiety and depression levels were considered clinically significant rather than just statistically significant.…”

Efetividade da laserterapia de baixa intensidade em mulheres com DTM dolorosa em função da ansiedade, cortisol salivar e ciclo menstrual: ensaio clínico randomizado controlado duplo-cego

“…A presença de DTM dolorosa leva a maior predisposição à ansiedade (REISSMANN et al, 2014) e indivíduos mais ansiosos são mais susceptíveis a perceberem dor nos quadros clínicos de DTM (DIRAÇOǦLU et al, 2016 (LAMBERT et al, 2013;JASIM et al, 2014;JO et al, 2016), em oposição a outros estudos que demostraram que esta diferença existe (SALAMEH et al, 2015;LIN et al, 2016). No presente estudo não foi verificada diferença nas dosagens do cortisol salivar de mulheres com DTM dolorosa em comparação à mulheres controles, bem como ao longo da LLLT.…”

“…Na dor crônica os eventos estressores são persistentes, de menor intensidade e variam de acordo com as características individuais de cada paciente. Portanto, é relevante considerar que haja habituação aos estímulos estressores na dor crônica, não ocasionando grandes flutuações no cortisol em comparação à indivíduos sem dor (LAMBERT et al, 2013;JASIM et al, 2014, JO et al, 2016.…”

“…Portanto, o estresse referido e o estresse mensurado por hormônios endógenos parecem não coincidir em pacientes com dor crônica, cuja carga emocional/afetiva tem papel determinante na manifestação clínica. A relação entre a dor crônica, a atividade do eixo HPA e o estresse psicológico é complexa e precisa ser melhor investigada em pesquisas futuras (JASIM et al, 2014, JO et al, 2016.…”

“…Neste estudo foi encontrada correlação entre a sensibilidade à dor (LDP) e o cortisol salivar, apesar deste não ser considerado um marcador biológico preciso na dor crônica (LAMBERT et al, 2013;JASIM et al, 2014, JO et al, 2016 (JONES et al, 1997;DOEPEL et al, 2009;NILSSON et al, 2010;JASIM et al, 2014;SALAMEH et al, 2015;TOSATO et al, 2015;JO et al, 2016 (FISCHER et al, 2009;VILANOVA et al, 2015).…”