Int J Stomatol

Int J Stomatol ›› 2024, Vol. 51 ›› Issue (3): 296-302.doi: 10.7518/gjkq.2024039

• Original Articles • Previous Articles     Next Articles

Differences in anxiety and depression in patients with different subtypes of temporomandibular disorders

Jing Zhang1,2(),Yisi Zhong3,Yunhao Zheng2,Li Zhang1,2,Xin Xiong2()   

  1. 1.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    3.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West-District Out-patient Section, West China Hospital of Stomatology, Sichuan University, Chengdu 610000, China
  • Received:2023-09-02 Revised:2023-12-22 Online:2024-05-01 Published:2024-05-06
  • Contact: Xin Xiong E-mail:12820265532@qq.com;drxiongxin@scu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(82301129);Clinical Research Project of West China Hospital of Stomatology, Sichuan University(LCYJ-2023-YY-2);Correspondence: Xiong Xin, Email: drxiongxin@scu.edu.cn

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Abstract:

Objective This study aimed to investigate the differences in anxiety and depression and their associated factors in various subcategories of patients with temporomandibular disorders (TMD) and to provide a basis for multidisciplinary treatment of TMD patients. Methods Sociodemographic information such as age, gender, education level, and per capita monthly household income of TMD patients were collected. Anxiety and depression were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Based on the DC/TMD diagnostic criteria, TMD was classified into three subtypes, namely, painful TMD (PT), intra-articular TMD (IT), and combined TMD (CT), which has PT and IT. R 4.2.2 was used for data processing and statistical analysis. Results Among the 362 TMD patients included in this study, 131 (36.2%) had anxiety and 153 (42.3%) had depression. A significant positive correlation existed between GAD-7 and PHQ-9 scores in patients with TMD (r=0.733, P<0.001; ρ=0.710, P<0.001). GAD-7 and PHQ-9 scores in patients with CT were significantly higher than those in patients with IT (P<0.001, P=0.002). GAD-7 scores were significantly negatively associated with male gender, per capita monthly household income of 3 000-6 000 RMB and higher than 6 000 RMB, and education level of college or bachelor’s degree. Meanwhile, GAD-7 scores were significantly positively associated with the CT subtype (P<0.05). PHQ-9 scores were significantly negatively associated with age, male gender, and per capita monthly household income higher than 6 000 RMB, whereas they were significantly positively associated with the CT subtype (P<0.05). Conclusion Approximately 40% of TMD patients had anxiety and depression. Anxiety and depression in patients with painful TMD should be given attention in clinical practice, and psychological interventions and multidisciplinary treatments may have better therapeutic outcomes for patients with painful TMD. Anxiety and depression in young patients, female patients, and patients with low income and education level were also noteworthy.

Key words: temporomandibular disorders, pain, anxiety, depression

CLC Number: 

  • R782.6

TrendMD: 

Tab 1

Patient baseline informations"

变量女性男性P值总体
人数/n（%）289（79.8）73（20.2）362
年龄（Me[Q1，Q3]）27.0[23.0，33.0]30.0[24.0，37.0]0.08827.0[23.0，34.0]
受教育水平/n（%）0.434
高中或中专及以下48（16.6）16（21.9）64（17.7）
大学专科或本科211（73.0）48（65.8）259（71.5）
研究生30（10.4）9（12.3）39（10.8）
家庭人均月收入*/n（%）0.023
<3 000元40（13.8）11（15.1）51（14.1）
3 000~6000元142（49.1）21（28.8）163（45.0）
>6 000元107（37.0）41（56.2）148（40.9）
GAD-7评分*/Me[Q1，Q3]4.0[1.0，7.0]1.0[0.0，4.0]<0.0013.0[1.0，6.0]
PHQ-9评分*/Me[Q1，Q3]4.0[1.0，8.0]2.0[1.0，5.0]0.0323.0[1.0，6.0]
TMD亚类/n（%）0.455
IT97（33.6）24（32.9）121（33.4）
PT57（19.7）19（26.0）76（21.0）
CT135（46.7）30（41.1）165（45.6）

Fig 1

Density map of patient distribution by gender and age"

Tab 2

Gender distribution of anxiety and depression emotions　 n（%）"

项目女性男性P值总体
焦虑情绪*0.004
没有174 （60.2）57 （78.1）231 （63.8）
轻微79 （27.3）12 （16.4）91 （25.1）
中度27 （9.3）3 （4.1）30 （8.3）
严重9 （3.1）1 （1.4）10 （2.8）
抑郁情绪0.061
没有161 （55.7）48 （65.8）209 （57.7）
轻微87 （30.1）21 （28.8）108 （29.8）
中度28 （9.7）3 （4.1）31 （8.6）
中重度10 （3.5）1 （1.4）11 （3.0）
严重3 （1.0）0 （0.0）3 （0.8）

Fig 2

Scatter plot of GAD-7 and PHQ-9 scores in patients with different subtypes of TMD"

Tab 3

Linear regression model for GAD-7 score and PHQ-9 score"

变量GAD-7评分PHQ-9评分
年龄

-0.004

（-0.05，0.04）

-0.05*

（-0.09，-0.009）

性别（以女性为参考）
男性

-1.94***

（-3.05，-0.83）

-1.34*

（-2.46，-0.22）

家庭人均月收入（以<3 000元为参考）
3 000~6 000元

-1.42*

（-2.79，-0.05）

-0.30

（-1.67，1.06）

>6 000元

-2.27**

（-3.65，-0.88）

-1.64*

（-3.03，-0.26）

受教育水平（以高中或中专及以下为参考）
大学专科或本科

-1.80**

（-2.99，-0.61）

-0.95

（-2.15，0.25）

研究生

-1.61

（-3.35，0.12）

-1.04

（-2.79，0.71）

TMD亚类（以IT为参考）
PT

0.94

（-0.31，2.18）

1.04

（-0.21，2.29）

CT

1.81***

（0.80，2.83）

1.38**

（0.35，2.40）

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