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Quantitative and Qualitative Gradient of Pain Experience, Sleep Quality and Psychological Distress in Patients with Different Phenotypes of Temporomandibular Disorders

Journal of Oral Medicine and Pain 2020년 45권 3호 p.56 ~ 64
최희훈, 김혜경, 김미은,
소속 상세정보
최희훈 ( Choi Hee-Hun ) - Ipyeonhan Dental Clinic
김혜경 ( Kim Hye-Kyoung ) - Dankook University College of Dentistry Department of Oral Medicine
김미은 ( Kim Mee-Eun ) - Dankook University College of Dentistry Department of Oral Medicine

Abstract


Purpose: Temporomandibular disorders (TMD) is a mosaic of clinical signs and symptoms that can be regarded as a set of phenotypes that are affected by various factors including pain sensitivity, pain disability, sleep and psychological functioning. The aims of this study were to evaluate association of pain experience, sleep quality and psychological distress with different phenotypes of TMD patients.

Methods: This retrospective study included a cohort (n=1,858; 63.8% for female, mean age=34.9±15.9 years) of patients with TMD. A set of self-administered questionnaires concerning pain interference (Brief Pain Inventory), pain disability (Graded Chronic Pain Scale), sleep quality (Pittsburg Sleep Questionnaire Index), psychological distress (Symptom Checklist- 90 revised), and pain catastrophizing (Pain Catastrophizing Scale) were administered to all participants at the first consultation. All TMD patients were classified into four groups including TMD with internal derangement without pain (TMD_ID, n=370), TMD with joint pain (TMD_J, n=571), TMD with muscle pain (TMD_M, n=541) and TMD with muscle-joint combined pain (TMD_MJ, n=376).

Results: The female ratio was particularly high in the group with TMD_MJ (p=0.001). The patients with muscle pain and both muscle and joint pain had longer symptom duration (p=0.004) and presented significantly higher scores in pain experience (p<0.001), subjective sleep quality (p<0.001), pain catastrophizing (p<0.001) and psychological distress (p<0.05) except for paranoid-ideation than the groups with only joint problems.

Conclusions: The results of this study highlight the importance of multi-dimensional approach that consider pain disability, sleep quality, and psychological functioning in the management of TMD with muscle component. This study would contribute to a better understanding of interaction between heterogeneous TMD and multiple risk factors in order to build tailored treatment based on different phenotypes.

키워드

Catastrophization; Pain; Phenotype; Psychological distress; Sleep; Temporomandibular disorder

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