国际口腔医学杂志 ›› 2024, Vol. 51 ›› Issue (3): 296-302.doi: 10.7518/gjkq.2024039
Jing Zhang1,2(),Yisi Zhong3,Yunhao Zheng2,Li Zhang1,2,Xin Xiong2(
)
摘要:
目的 探讨颞下颌关节紊乱病(TMD)不同亚类患者焦虑抑郁情绪的差异及其关联因素,为TMD患者的多学科治疗提供依据。 方法 收集TMD患者的年龄、性别、受教育水平、家庭人均月收入等社会人口学信息,使用广泛性焦虑症量表7(GAD-7)和患者健康问卷9(PHQ-9)评估患者的焦虑和抑郁情绪。基于DC/TMD 诊断标准将TMD分为疼痛类TMD(PT)、关节类TMD(IT)以及同时具备PT和IT的复合性TMD(CT)3个亚类,采用R 4.2.2进行数据处理和统计分析。 结果 在纳入的362名TMD患者中,131人(36.2%)有焦虑情绪,153人(42.3%)有抑郁情绪。TMD患者的GAD-7和PHQ-9评分存在显著正相关(r=0.733,P<0.001;ρ=0.710,P<0.001),CT患者的GAD-7和PHQ-9评分显著高于IT患者(P<0.001,P=0.002)。GAD-7评分与男性性别、家庭人均月收入3 000~6 000元以及高于6 000元和受教育水平为大学专科或本科显著负相关,而与CT亚类显著正相关(P<0.05);PHQ-9评分与年龄、男性性别以及家庭人均月收入高于6 000元显著负相关,而与CT亚类显著正相关(P<0.05)。 结论 约40%的TMD患者具有焦虑抑郁情绪,临床实践中应关注疼痛类TMD患者的焦虑抑郁情绪,联合心理干预的多学科治疗可能对疼痛类TMD患者有更好的治疗效果。此外,年轻患者、女性患者、低收入和低受教育水平患者的焦虑抑郁情绪也值得注意。
中图分类号:
1 | Durham J, Newton-John TRO, Zakrzewska JM. Tem-poromandibular disorders[J]. BMJ, 2015, 350: h1154. |
2 | Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era[J]. J Oral Rehabil, 2017, 44(11): 908-923. |
3 | Bond EC, Mackey S, English R, et al. Temporomandibular disorders: priorities for research and care[M]. Washington, DC: The National Academies Press, 2020. |
4 | Dutra Dias H, Botelho AL, Bortoloti R, et al. Neuroscience contributes to the understanding of the neurobiology of temporomandibular disorders associa-ted with stress and anxiety[J]. Cranio, 2021: 1-6. |
5 | Chen H, Pendleton C, Caplan DJ, et al. Chairside risk assessment for first-onset temporomandibular di-sorders: result from the orofacial pain: prospective evaluation and risk assessment data set[J]. J Am Dent Assoc, 2021, 152(7): 505-513.e2. |
6 | Penlington C, Bowes C, Taylor G, et al. Psychological therapies for temporomandibular disorders (TMDs) [J]. Cochrane Database Syst Rev, 2022, 8(8): CD013515. |
7 | Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group[J]. J Oral Facial Pain Headache, 2014, 28(1): 6-27. |
8 | Keller S, Bocell FD, Mangrum R, et al. Patient-reported outcome measures for individuals with temporomandibular joint disorders: a systematic review and evaluation[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2023, 135(1): 65-78. |
9 | Cao Y, Yap AU, Lei J, et al. Oral health-related qua-lity of life of patients with acute and chronic temporomandibular disorder diagnostic subtypes[J]. J Am Dent Assoc, 2022, 153(1): 50-58. |
10 | Zhu R, Zhang L, Zheng YH, et al. Association between stigma and pain in patients with temporomandibular disorders[J]. Int J Clin Pract, 2022, 2022: 2803540. |
11 | Cao Y, Yap AU, Lei J, et al. Subtypes of acute and chronic temporomandibular disorders: their relation to psychological and sleep impairments[J]. Oral Dis, 2021, 27(6): 1498-1506. |
12 | 张玉向, 梁峰, 汤政, 等. 脑内5-羟色胺受体6对疼痛与焦虑、抑郁调节的研究进展[J]. 神经解剖学杂志, 2016, 32(5): 660-664. |
Zhang YX, Liang F, Tang Z, et al. Research pro-gress on the regulation of 5-hydroxytryptamine receptor 6 in the brain on pain, anxiety, and depression[J]. Chin J Neuroanat, 2016, 32(5): 660-664. | |
13 | Hooten WM. Chronic pain and mental health disorders[J]. Mayo Clin Proc, 2016, 91(7): 955-970. |
14 | Ye C, Xiong X, Zhang YY, et al. Psychological profiles and their relevance with temporomandibular disorder symptoms in preorthodontic patients[J]. Pain Res Manag, 2022, 2022: 1039393. |
15 | Su N, Lobbezoo F, van Wijk A, et al. Associations of pain intensity and pain-related disability with psychological and socio-demographic factors in patients with temporomandibular disorders: a cross-sectional study at a specialised dental clinic[J]. J Oral Rehabilitation, 2017, 44(3): 187-196. |
16 | Zhang QB, Yuan SS, Deng KT, et al. Correlation of patients’ demographics and clinical symptoms with temporomandibular disorders[J]. Cranio, 2023, 41(5): 432-439. |
17 | Bueno CH, Pereira DD, Pattussi MP, et al. Gender differences in temporomandibular disorders in adult populational studies: a systematic review and meta-analysis[J]. J Oral Rehabil, 2018, 45(9): 720-729. |
18 | National Center for Health Statistics. National heal-th interview survey-2018 data release[EB/OL]. (2021-06-14)[2023-04-06]. . |
19 | 唐军, 郁春华, 程蕙娟, 等. DC/TMD推荐心理量表在颞下颌关节紊乱病诊疗中的应用[J]. 上海口腔医学, 2023, 32(1): 109-112. |
Tang J, Yu CH, Cheng HJ, et al. Application of psychological scales recommended by DC/TMD in patients with temporomandibular joint disorders[J]. Shanghai J Stomatol, 2023, 32(1): 109-112. | |
20 | 傅小兰, 张侃, 陈雪峰, 等. 中国国民心理健康发展报告(2021~2022)[M]. 北京: 社会科学文献出版社, 2023. |
Fu XL, Zhang K, Chen XF, et al. Report on national mental health development (2021-2022)[M]. Beijing: Social Science Academic Press, 2023. | |
21 | Hallers-Haalboom ET, Maas J, Kunst LE, et al. The role of sex and gender in anxiety disorders: being scared “like a girl”[J]. Handb Clin Neurol, 2020, 175: 359-368. |
22 | Théaudin M, Romero K, Feinstein A. In multiple sclerosis anxiety, not depression, is related to gender[J]. Mult Scler, 2016, 22(2): 239-244. |
23 | Ridley M, Rao G, Schilbach F, et al. Poverty, depression, and anxiety: causal evidence and mechanisms[J]. Science, 2020, 370(6522): eaay0214. |
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