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Aims: To examine the relationship between depression and somatization and pain during muscle and joint palpation as well as limitations related to mandibular functioning (LRMF) in patients with temporomandibular disorders. Methods: The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) data for Axes I and II for 196 consecutive patients (56 men and 140 women) with a history of facial pain were obtained. The mean age of the predominantly Chinese patient population (83.2%) was 33.4 years frange 18 to 55 years). A computerized diagnostic system was used to collect the RDC/TMD history data. The Symptom Check List (SCL-90) depression and somatization scales were generated on-line and archived. The mean muscle pain (MP), joint pain UP), and LRMF scores were computed with depression and somatization as main effects. Data were subjected to analysis of variance (Scheffe test) and Pearson's correlation at a significance level of .05. Results: Depression scores ranged from 4.03 to 8.16 (MP), from 0.67 to 1.03 UP), and from 0.30 to 0.38 (LRMF); somatization scores ranged from 2.64 to 7.75 (MP), from 0.58 to 1.00 (JP), and from 0.30 to 0.41 (LRMF). Interaction effects between depression and somatization were not significant. Patients with severe depression had significantly higher MP scores than normal patients or patients with moderate depression. Patients with moderate and severe somatization had significantly higher MP scores than normal patients. LRMF scores of patients with severe somatization were significantly greater than those who were normal or suffered from moderate somatization. No significant difference in JP scores was observed for depression and somatization scales. Correlations between depression/somatization and MP, JP, and LRMF scores were significant and positive but weak; coefficients ranged from 0.15 to 0.41. Conclusion: The results suggest that depression and somatization are related to the self-report of MP. In addition, severe somatization may be associated with an increase in jaw disability. [ABSTRACT FROM AUTHOR]

Aims: To use the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) to investigate the physical diagnoses, psychologic distress, and psychosocial dysfunction in Asian TMD patients. The RDC/TMD Axis I and II findings were compared to those of Swedish and American TMD patients. Methods: One hundred ninety-one patients (53 male and 138 female) referred to 2 institutionalized TMD clinics in Singapore were enrolled in the study. The mean age of the predominantly Chinese population (83.2%) was 33.6 ± 9.3 years. Data from a RDC/TMD history questionnaire and clinical examination were fed directly by patients and clinicians into a computerized diagnostic system (NUS TMDv1.1). Axis I and II findings were generated on-line, based on RDC/TMD rule engines. Data were automatically exported to SPSS for statistical analysis. Results: Group I (muscle) disorders were found in 31.4% of the patients; Group II (disc displacement) disorders were found in 15.1% and 15.7% of the patients in the left and right temporomandibular joints, respectively; and Group III (arthralgia, arthritis, and arthrosis) disorders were found in 12.6% and 13.0% of the patients in the left and right joints, respectively. Axis II assessment of psychologic status showed that 39.8% of patients experienced moderate to severe depression and 47.6% had moderate to severe nonspecific physical symptom scores. Psychosocial dysfunction was observed in only 4.2% of patients based on graded chronic pain scores. Conclusion: Axis I and II findings of Asian TMD patients were generally similar to their Swedish and American cohorts. In all 3 populations, women of child-bearing age represented the majority of patients. Muscle disorders were the most prevalent type of TMD. A substantial portion of TMD patients were depressed and experienced moderate to severe somatization. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed multiple pain conditions and their association with psychosocial functioning, psychologic distress, and somatization in patients with temporomandibular disorders (TMD) based on RDC/TMD Axis II findings. Nonspecific pain items examined included headaches, heart/chest pain, lower back pain, nausea/abdominal pain, and muscle pain. Materials and Methods: In this study, 202 TMD patients (58 men and 144 women) referred to two TMD clinics participated. The mean age of the predominantly Chinese patient population (82%) was 32.6 years (range 13 to 65). The RDC/TMD history questionnaire was input directly into computers by patients. Graded chronic pain and SCL-90 scales were generated online and automatically archived for statistical analysis. Data were subjected to Spearman's rank-order correlation and Kruskal-Wallis and Mann-Whitney tests at a significance level of .05. Results: Of the patients, 43% were moderately to extremely distressed by headaches. The percentage of patients who were distressed by heart/chest pain (7%), lower back pain (26%), nausea/abdominal pain (17%), and soreness of muscles (22%) was lower. Of the TMD patients, 16% experienced more than three pain items. Significant and positive correlations were observed between number of pain items experienced and graded chronic pain severity, depression, and somatization. Correlation coefficients ranged from .27 to .65 for graded chronic pain scales and somatization (without pain items) scores, respectively. Conclusion: Results suggest that the number of nonspecific pain conditions reported may be a predictor of psychosocial dysfunction, depression, and somatization. [ABSTRACT FROM AUTHOR]

The expression of depression in Asian temporomandibular disorder (TMD) patients may differ from that of their Caucasian counterparts. This study examined the prevalence of depressive symptoms and their association with non-specific physical symptoms (NPSs) reporting in Asian patients. Two hundred and fifty-five Asian TMD patients (68 males; 187 females) with a mean age of 33.0 years were selected for this study. Research diagnostic criteria (RDC)/TMD history questionnaire was input directly into computers by patients using the NUS TMDv.1.1 software. Symptom Checklist 90 (SCL-90) depression and NPS scales were generated online and automatically archived for statistical analysis. Data were subjected to ANOVA/Scheffe's test and Pearson's correlation at significance level 0.05 and 0.01, respectively. 43.1 and 50.6% of the patients scored moderate-to-severe on the depression and NPS scales, respectively. The percentage of patients with diffuse physical symptoms remained high (45.5%), even after pain items were excluded from the computation. NPS scores ranged from 0.34 to 1.64, while depression scores ranged from 0.27 to 1.21. A significant and positive correlation ( r = 0.74) was observed between depression and NPS scores. The prevalence of depressive symptoms and NPSs was lower in Asian TMD patients. Psychological distress experienced by female Asian TMD patients was comparable to their male counterparts. Results also suggest that depressive symptomatology is associated with the reporting of multiple NPSs. J Oral Pathol Med (2004) 33: 305–10 [ABSTRACT FROM AUTHOR]

This study investigated the clinical temporomandibular disorders (TMD), pain-related disability and psychological status of TMD patients using a computerized on-line TMD diagnostic system (NUS TMD v1·1). A total of 107 patients (32 male, 75 female) referred to the TMD clinics at the National Dental Centre and National University Hospital participated in this study. The mean age of the predominantly Chinese population (82·2%) was 30·8 years (range from 12 to 64 years). The history questionnaire and clinical examination were input directly into computers by patients and clinicians. A `Summary of Findings' was then immediately generated by the program based on Axis I and II rules. The data was subsequently exported to SPSS for statistical analysis. About 20·6% of the patients had myofascial pain but only 7·5% experienced limited mandibular opening associated with myofascial pain. The majority of patients (> 80%) did not suffer from disc displacements (right and left joints). The frequency of arthralgia was also low (right joint 8·4%; left joint 7·5%) and only one patient had osteoarthosis of the TMJ. About 78·5% of the patients had low disability with almost equal distribution between low and high intensity pain, 27·1% of the patients were moderately depressed and 11·2% had severe depression. No significant difference in limitations related mandibular functioning scores was observed between normal/depressed patients and between patients with the different graded chronic pain severity classification. The three most frequent jaw disabilities were: eating hard foods (77·6%), yawning (75·7%) and chewing (64·5%). NUS TMD v1·1 is an extremely useful tool in the diagnosis/research of clinical TMD. [ABSTRACT FROM AUTHOR]