A spectrum approach for the assessment of manic-depressive symptoms accompanying temporomandibular disorders

Temporomandibular disorders (TMD) are a number of conditions which are
frequently associated with depressive symptoms, but the possible existence of
some form of manic-depressive illness in TMD patients has never been
investigated. The aims of this work were to evaluate the reliability of a newly
adopted spectrum model of psychopathology to detect depressive symptoms in TMD
patients, and to produce pilot data on the presence of manic symptoms in TMD
patients. METHODS: Ninety-one consecutive TMD patients (72 females, 19 males;
mean age 26.3) and 26 TMD-free subjects (21 females, 5 males; mean age 24) were
administered a validated questionnaire to evaluate mood spectrum (MOODS-SR).
Helkimo's Clinical Dysfunction Index (CDI) was calculated for all patients.
One-way ANOVA and Bonferroni's post-hoc test for multiple comparisons were used
to compare mean MOODS-SR scores of the groups identified as TMD-free (CDI=0),
mild dysfunctionals (CDI=1), moderate or severe dysfunctionals (CDI= or >2).
RESULTS: Total scores of domains evaluating depression were significantly higher
in moderate or severe dysfunctionals than in both TMD-free (mean difference
8.87+/-3.5; p=0.017) and mild dysfunctionals (m.d. 9.41+/-2.62; p=0.001). As
regards manic symptoms, differences between groups were not significant (F=1.299;
p=0.277). CONCLUSION: Our findings support the reliability of MOODS-SR to detect
depressive symptoms associated with TMD. The hypothesis that depressive symptoms
in TMD patients could be an expression of a more complex manic-depressive illness
has to be rejected, since no differences between TMD patients and TMD-free
subjects have been revealed for the presence of manic symptoms.