How does depression influence the pain drawings of patients 
with orofacial pain?

Objective: This study of orofacial pain patients aimed to investigate the relationship of the degree of preexisting depression with pain distribution and a modified Ransford score (MRS).
Materials and methods: Patients with non-odontogenic orofacial pain were consecutively recruited on first presentation at the University of Heidelberg University Clinic for Prosthodontics. All participants completed the Patient Health Questionnaire 9 (PHQ-9) for depression severity and the new pain drawings (PDs) from the DC/TMD. The PDs were rated in terms of dermatomal pain distribution (DPD) and MRS. Nonparametric statistics were used to analyze the data (significance level: P ≤ 0.05).
Results: A total of 218 patients (average age: 41.9 years, n = 50 male) were included in the final study. The DPD analysis showed that 56% of patients (n = 122) had pain extending beyond dermatome C4. PHQ-9 scores (mean with standard deviation) were 8.23 ± 6.73 in males and 7.82 ± 6.25 in females. Increased PHQ-9 scores of ≥ 10 points, which indicate a high probability of moderate to severe depression, were detected in 73 (33.5%) patients overall. Compared with females, males with a higher PHQ-9 score had significantly less localized pain (c22(1) = 4.118, P = 0.042). Patients with a higher PHQ-9 score did not have significantly higher MRS values than those with a lower PHQ-9 score (P = 0.109, Mann-Whitney U test).
Conclusion: Based on the available data, it seems that the DPD and MRS of patients’ PDs are not valid predictors of the severity of depression. Palabras clave: pain drawing, orofacial pain, dermatomes, depressive disorder