Investigation of the Psychological Status of 162 Female TMD Patients with Different Chronic Pain Severity

Objective: To evaluate the level of psychosocial difficulties in patients with temporomandibular disorders (TMD) by using the Symptom Checklist 90 revised (SCL-90-R), and determine whether there is an association between psychosocial status and chronic pain severity. Methods: One hundred and sixty-two female patients who came to the Center for TMD and Orofacial Pain of Peking University Hospital of Stomatology were randomly included in this study. SCL-90-R was used to assess the psychological status of the TMD patients. This instrument was also used to assess psychological status and pain-related disability in chronic pain patients and a seven-item questionnaire was used to grade chronic pain severity (GCP). Univariate analysis of variance and correlation analysis were performed to determine the association between psychological status and chronic pain severity. Results: A total of 126 female TMD patients complained of pain in the temporomandibular joint. One hundred and sixteen patients had low disability, with 83 (51.3%) having low intensity pain (Grade I), 30 (18.5%) having high intensity pain (Grade II) and only 13 (8%) with high disability (Grade III pain). The patients were divided into four groups according to their GCP scores. The scores of all the factors of SCL-90-R were significantly different among the groups. The incidence of psychosocial symptoms was also significantly different among the groups. The psychosocial status of patients with high disability was the worst among the four groups. Conclusion: The GCP severity is a suitable tool to assess the psychosocial and physical status of TMD chronic pain. Some TMD patients have psychological problems and symptoms of psychopathology, especially those with high disability. Physicians should keep this possibility in mind when treating patients with TMD chronic pain. Keywords: chronic pain, disorders psychology, Symptom Checklist 90, temporomandibular