Personality and psychopathology in patients with temporomandibular joint pain-dysfunction syndrome - A controlled investigation

Objective: Our aim was to deepen the understanding of the psychosomatic asp ects of temporomandibular joint (TMJ) pain dysfunction syndrome. Patients a ffected by this syndrome were compared with both healthy subjects and psych iatric patients, using both self-report and physician-scored psychological measures. Methods: Three sex- and age-matched groups were recruited: a TMJ group (n = 32), a healthy group (n = 22) and a psychiatric group (n = 22). The psychiatric group consisted of outpatients diagnosed as having a DSM-IV anxiety or depressive disorder of mild to moderate severity. Psychometric assessment included the Minnesota Multiphasic Personality Inventory (MMPI) and the Hamilton Anxiety Rating Scale (HARS). Results: Psychiatric patients scored higher than both the comparison groups on all but one of the MMPI s cales; the majority of the differences were significant or approached signi ficance, TMJ patients scored higher than healthy controls on the Hs (hypoch ondriasis; p less than or equal to 0.01), Hy (hysteria; p less than or equa l to 0.01) and D (depression; p less than or equal to 0.05) scales. Psychia tric patients scored higher than TMJ patients on the HARS psychic anxiety s ubscale (p I 0.05), while TMJ patients scored higher than psychiatric patie nts on the somatic anxiety subscale (p less than or equal to 0.05). Conclus ions: Certain personality characteristics were associated with TMJ dysfunct ion. However, further longitudinal studies should be performed to properly assess causal relationships. Despite signs of neuroticism, anxiety and depr ession, patients with TMJ dysfunction differed from anxious and depressed p atients, While the latter displayed a higher level of psychopathology, each group was characterised by a distinct pattern of anxiety symptoms. In addi tion, a substantial proportion of TMJ patients had little awareness of thei r inner states and emotions. Copyright (C) 2000 S. Karger AG, Basel.