Post-traumatic Stress Disorder Among Patients with Orofacial Pain

Aims: To examine the presence and impact of post-traumatic stress disorder (PTSD) in a sample of patients seeking treatment for orofacial pain. Methods: One hundred forty-one consecutive patients with an array of orofacial pain conditions were screened using a structured clinical interview for PTSD and the PTSD Symptom Checklist-Civilian Version (PCL), a brief PTSD self-report inventory. Additionally, participants received a clinical examination and self-report questionnaires to assess pain, coping styles, and presence of post-traumatic symptoms. Results: Thirty-three (23%) patients received a full lifetime or current PTSD diagnosis, with an additional 11 patients receiving a partial PTSD diagnosis. Only 5 of these 44 patients had ever been previously diagnosed with PTSD. PTSD symptoms were associated with higher pain scores (P .05) and affective distress (P .01). Furthermore, discriminant function analyses suggested that the PCL accurately classified 89% of these cases (sensitivity = .85, specificity = .90, postive predictive power = 74%, negative predictive power = 95%). Conclusion: These results suggest that PTSD is prevalent in the orofacial pain setting and that PTSD symptomatology is associated with increased pain and affective distress that may complicate clinical presentation. Furthermore, PTSD can be accurately and efficiently assessed using a brief, self-report inventory. Keywords: orofacial pain, post-traumatic stress disorder, temporomandibular disorders