不同类型颞下颌关节紊乱病患者焦虑抑郁情绪的差异  

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

作　　者：张静[1,2] 钟亦思[3] 郑耘昊 张莉[1,2] 熊鑫 Zhang Jing;Zhong Yisi;Zheng Yunhao;Zhang Li;Xiong Xin(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;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;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)

机构地区：[1]口腔疾病防治全国重点实验室、国家口腔医学中心、国家口腔疾病临床医学研究中心、四川大学华西口腔医院口腔全科,成都610041 [2]口腔疾病防治全国重点实验室、国家口腔医学中心、国家口腔疾病临床医学研究中心、四川大学华西口腔医院颞下颌关节科,成都610041 [3]口腔疾病防治全国重点实验室、国家口腔医学中心、国家口腔疾病临床医学研究中心、四川大学华西口腔医院西区门诊部,成都610000

出　　处：《国际口腔医学杂志》2024年第3期296-302,共7页International Journal of Stomatology

基　　金：国家自然科学基金(82301129);四川大学华西口腔医院新技术项目(LCYJ-2023-YY-2)。

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3000~6000元以及高于6000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6000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。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 3000-6000 RMB and higher than 6000 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 6000 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 notewo

关 键 词：颞下颌关节紊乱病 疼痛 焦虑 抑郁 

分 类 号：R782.6[医药卫生—口腔医学]