Temporomandibular Disorders in Psychiatric Outpatients: A Hidden Epidemic?

BACKGROUND

Temporomandibular disorders (TMD) are a multimodal group of orofacial pain syndromes that rank behind only chronic low back pain in the list of most prevalent musculoskeletal conditions causing pain and disability. Previous studies have recorded high rates of comorbid anxiety, depression, and poor sleep quality among TMD patients.

METHODS

Eighty five outpatients recruited from Rhode Island Hospital's Latino and Portuguese Mental Health Programs completed the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and the Pittsburgh Sleep Quality Index questionnaire (PSQI). The latest meta-analysis of TMD prevalence in the general population was used for the reference population (n = 3159).

RESULTS

The most prevalent psychiatric disorders were depressive disorders (75.3%), anxiety disorders (57.6%), and sleep-wake disorders (47.1%). Fifty patients (58.8%) met criteria for TMD, versus 29.3% in the reference population (p < 0.001). In our sample, the PSQI cut-off for poor sleep was crossed in 96.2% of patients with TMD and 82.9% of those without TMD (p = 0.041).

OBJECTIVES

We sought to establish the prevalence of TMD in a significant sample of psychiatric outpatients, considering their psychiatric diagnoses and sleep quality.

CONCLUSION

The very high prevalence of TMD among patients with depression, anxiety, and sleep disorders reinforces their association and alerts us to the possibility of TMD constituting a widespread, though largely ignored, comorbidity of psychiatric outpatients that may be impacting their mental health outcomes. Further studies are needed to clarify the value of screening this population for TMD and to establish which cases merit treatment.