Correlates of jaw functional limitation, somatization and psychological distress among different temporomandibular disorder diagnostic subtypes

Objectives: This study investigated the jaw functional status and severity of somatic/psychological symptoms in different Diagnostic Criteria for temporomandibular disorders (DC/TMD) diagnostic subtypes and established the correlates between jaw functional limitation, somatization, depression and anxiety.Methods: Data were accrued from consecutive 'first-visit' patients seeking TMD treatment at a university-based oral medicine/diagnosis clinic. Axis I physical TMD diagnoses were derived using the DC/TMD methodology and patients were categorized into pain-related (PT), intra-articular (IT) and combined (CT) TMD groups. Axis II measures were also administered and included the Jaw Functional Limitation Scale-20 (JFLS-20), Patient Health Questionnaire-15 and 9 (PHQ-15 and PHQ-9) and General Anxiety Disorder Scale-7 (GAD-7). Chi-square/Kruskal-Wallis tests and Spearman's correlation were employed for statistical evaluations (alpha = .05).Results: The final dataset consisted of 772 TMD patients (mean age of 37.7 +/- 15.9 years; 70.2% females). The prevalence of PT, IT and CT was 11.9%, 15.7% and 72.4%, respectively. Significant differences in functional jaw limitations, somatization, depression (CT, PT > IT) and anxiety (CT > PT, IT) were observed. Moderate-to-severe somatization, depression and anxiety were detected in 12.6%-15.7% of patients. For all three TMD groups, JFLS global scale/subscale scores were weakly associated with somatization, depression and anxiety scores (r(s) < 0.4). Moderate-to-strong correlations were noted between somatization, depression and anxiety (r(s) = 0.50-0.74).Conclusions: Functional jaw limitations were associated with painful TMDs but appear to be unrelated to somatization and psychological distress. Somatization and depression/anxiety were moderately correlated, underscoring the importance of somatic symptom screening when managing TMD patients.

Automated summary

This study found that functional jaw limitations were associated with painful TMDs but unrelated to somatization and psychological distress. There was a moderate correlation between somatization and depression/anxiety, emphasizing the importance of screening for somatic symptoms when managing TMD patients.