Evaluation of the psychological factors and symptoms of pain in patients with temporomandibular disorder

ABSTRACT

Introduction: The influence of psychological factors on temporomandibular disorders (TMD), such as depression, anxiety and stress has been very discussed in literature. However, there is no consensus about their influence on the clinical manifestation of TMD. Objective: To evaluate the evolution of minor psychiatric disorders and pain symptoms in patients with temporomandibular disorders (TMD) treated with occlusal splints and rehabilitated with dental prosthesis. Material and methods: Sixty volunteers, both genders, aging from 20 to 65 years, diagnosed with TMD, were randomly selected within the university's patient databank. The volunteers were divided into two groups: G1 - 30 males and G2 - 30 females. The volunteers underwent a standard clinical evaluation for TMD diagnosis. Psychological evaluations were performed through Goldberg's General Health Questionnaire (GHQ), before and after 24 months of treatment. TMD treatment comprised occlusal splints and rehabilitated with dental prosthesis. The results were evaluated by Mantel-Haezel, Wilcoxon and Mann-Whitney statistical tests. Results: According to the criteria established by GHQ, the interpretation of the symptom scores should be applied based on gender, because the scores have different values for male and female, consequently no comparisons were made between the groups. There were significant statistical difference in G2 when the variables psychic stress (p = 0.002) and psychosomatic disorders (p = 0.007) were observed.In G1, the variables for psychosomatic disorders (p = 0.002) and general health (p = 0.021) were statistically significant. Significant differences were found in both groups for all the evaluated symptoms (p < 0.005). Conclusion: The used therapy positively interfered in the remission of symptoms and in the incidence of minor psychic disorders of TMD patients.