Abstract
This study investigated the relationship between psychological properties and treatment outcome. The visual analogue scale (VAS), Cornell Medical Index (CMI), Self Rating Depression Scale (SDS) and Modified Taylor Manifest Anxiety Scale (MAS) were used to evaluate 50 patients with temporomandibular disorder (TMD) (8 male, 42 female; mean age of 38.0 y). All the psychological questionnaires were recorded before treatment. The first VAS (VAS 1) was recorded before treatment and the second, VAS 2, representing subjective symptoms after treatment, 6 months after the initial visit to our clinic. Treatment outcomes were assessed in terms of the differences between VAS 1 and VAS 2 (VAS 1 - 2).
In VAS 1, the group with a tendency towards depression had higher scores for daily life disturbance than patients without that tendency (p<0.05; Mann-Whitney U-test). In VAS 2, the anxiety of the high-anxiety group remained as high as in VAS 1 in the categories of daily life disturbance, spontaneous pain, pain during mastication and pain on opening. In VAS 1 - 2, there were significant differences between groups in the normal range and groups outside the normal range in all psychological questionnaires in the categories of the daily life disturbance, spontaneous pain, pain during mastication and pain on opening, but no significant difference was observed regarding the difficulty of opening.
The cause-effect relationships between these psychological properties and TMD symptom are unclear, but prognosis was possible based on those properties. The likelihood of treatment succeeding was higher for patients who revealed no problems in the psychological questionnaires, using their own subjective evaluations.
