General and Health Anxiety in Temporomandibular Disorders: Correlates With Depression, Pain Intensity, Sleep Propensity, Oral Behaviours, Jaw Function, and Oral Health-Related Quality of Life.

BACKGROUND

Health anxiety (HA) has been underexplored in temporomandibular disorders (TMDs). This study compared general anxiety (GA) and HA across TMD subtypes, examining correlations with depression, pain intensity, sleep propensity, oral behaviours, jaw function, and oral health-related quality of life (OHRQoL).

METHODS

Participants recruited from TMD patients completed a survey with the General Anxiety Disorder-7 Scale, Whitely Index-8, relevant DC/TMD Axis II measures, Epworth Sleepiness Scale, and Oral Health Impact Profile for TMDs, followed by a physical examination. They were subsequently categorised into Intra-Articular (IT), Pain-Related (PT), and Combined (CT) TMD groups based on DC/TMD algorithms. Data were analysed using the Chi-square Test, non-parametric tests, and logistic regression (α = 0.05).

RESULTS

Among the 371 participants (mean age 29.8 years; 79.5% female), moderate-to-severe GA and depression were found in 15.1%, and high HA was noted in 19.7%. Significant differences were observed across the three TMD subtypes in the proportion of females (CT > PT/IT), age, GA, HA, depression, pain intensity, jaw functional limitation (PT/CT > IT), and OHRQoL (CT ≥ PT > IT). GA was strongly correlated with HA and depression and moderately correlated with OHRQoL, while HA was moderately correlated with both depression and OHRQoL (rs = 0.60-0.77). The multivariate model indicated that CT (OR 2.86), GA (OR 1.35), HA (OR 1.13), pain intensity (OR 1.03), and jaw functional limitation (OR 1.04) significantly increased the odds of low OHRQoL.

CONCLUSIONS

One-fifth of TMD patients exhibited HA, which was moderate to strongly correlated with GA and depression. GA and HA appear to have a greater impact on OHRQoL than depression.