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Research Diagnostic Criteria Axis II in Screening and as a Part of Biopsychosocial Subtyping of Finnish Patients with Temporomandibular Disorder Pain




TekijätSuvinen TI, Kemppainen P, Le Bell Y, Valjakka A, Vahlberg T, Forssell H

KustantajaQUINTESSENCE PUBLISHING CO INC

Julkaisuvuosi2013

JournalJournal of Orofacial Pain

Tietokannassa oleva lehden nimiJOURNAL OF OROFACIAL PAIN

Lehden akronyymiJ OROFAC PAIN

Numero sarjassa4

Vuosikerta27

Numero4

Aloitussivu314

Lopetussivu324

Sivujen määrä11

ISSN1064-6655

DOIhttps://doi.org/10.11607/jop.1145


Tiivistelmä
Aims: To assess Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II variables in an initial psychosocial screening and as a part of biopsychosocial subtyping of Finnish referral patients with TMD pain for adjunct multidisciplinary assessment. Methods: Consecutive Finnish referral patients with TMD pain (n = 135) participated in this questionnaire-based survey. Psychosocial screening was based on Graded Chronic Pain Scale (GCPS) and culturally adjusted Symptom Checklist 90-revised (SCL-90R) depression scale scores and subtyping on GCPS pain-related interference in accordance with previous treatment tailoring studies. Biopsychosocial subtyping variables included symptoms of depression and somatization, general health, pain-related worry, sleep dysfunction, and coping ability. Subtype comparisons were analyzed with Bonferroni adjusted P values and multivariable logistic regression (SAS 9.3). Results: Based on psychosocial screening, 44% of the patients were psychosocially uncompromised (TMD subtype 1), 33% moderately, and 23% severely compromised (TMD subtypes 2 and 3). Compared to TMD subtype 1, TMD subtype 2 patients reported intermediate scores, and the most vulnerable TMD subtype 3 had the poorest general health, most elevated depression, somatization, worry and sleep dysfunction, and poor coping ability (P < .05). According to multivariable logistic regression, depression and worry levels were significantly higher in TMD subtype 3 compared to TMD subtype 1, whilst patients in TMD subtypes 1 and 2 reported significantly better coping ability compared to TMD subtype 3 (P < .05). Conclusion: The Finnish RDC/TMD Axis II was found reliable in initial TMD pain patient screening and with further biopsychosocial assessment identified three main TMD subtypes, two with compromised psychosocial profiles for adjunct multidisciplinary assessment.



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