Psychosocial Assessment of Patients With Temporomandibular Disorders (TMD). Suitability of the Finnish Version of Diagnostic Criteria for TMD Axis II Instruments
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Markku Larmas auditorium (H1091), Dentopolis, Oulu
Topic of the dissertation
Psychosocial Assessment of Patients With Temporomandibular Disorders (TMD). Suitability of the Finnish Version of Diagnostic Criteria for TMD Axis II Instruments
Doctoral candidate
DDS Maria Hietaharju
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Population Health
Subject of study
Stomatognathic Physiology
Opponent
Dosentti Jenni Hjerppe, The University of Zurich
Custos
Professor Kirsi Sipilä, Research Unit of Population Health, University of Oulu
Psychosocial Assessment of Patients With Temporomandibular Disorders (TMD). Suitability of the Finnish Version of Diagnostic Criteria for TMD Axis II Instruments
Biopsychosocial factors have an important role in the background of temporomandibular disorders (TMD). Diagnostic Criteria for TMD (DC/TMD) have recently been developed based on the previous RDC/TMD (Research Diagnostic Criteria for TMD). Both criteria include Axis I for clinical diagnoses and Axis II for psychosocial assessment.
The aim of the study was to compare the Finnish versions of the RDC/TMD and DC/TMD Axis II instruments and to evaluate their internal reliability. The study also compared the applicability of Graded Chronic Pain Scale (GCPS 1.0 in RDC/TMD-FIN vs. 2.0 in DC/TMD-FIN) pain intensity/interference assessments for biopsychosocial subtyping of TMD pain patients. The aim was also to evaluate the association of pain-related intensity/interference with the outcome of conservative treatment of TMD.
The first study sample included 197 TMD pain patients from Finnish university hospitals. The patients filled in DC/TMD-FIN and RDC/TMD-FIN Axis II questionnaires and questionnaires with additional pain-related, biopsychosocial and treatment-related variables. The patients were clinically examined based on DC/TMD Axis I protocol. They were categorized into TMD subtypes 1–3 according to GCPS 1.0 and 2.0. In another study sample, 80 TMD pain patients in tertiary care were categorized into TMD subtypes 1–3 based on GCPS 1.0 at baseline. Patients were treated conservatively. At follow-up visits during 1 year they evaluated their pain intensity and described the treatment outcome and TMD symptom severity.
The DC/TMD and RDC/TMD Axis II psychosocial instruments showed significant correlation and high internal reliability and internal inter-item consistency. Patients in TMD subtype 3 had biopsychosocial symptoms and reported previous healthcare visits significantly more often than the others. In the follow-up study, patients with TMD subtype 3 described their symptoms as most severe at each follow-up.
The Finnish versions of the DC/TMD Axis II psychosocial instruments show high validity and internal consistency and are thus applicable to Finnish TMD pain patients in tertiary care. GCPS 2.0 is suitable for categorizing tertiary care TMD pain patients into biopsychosocially relevant subtypes. Moderate/severe pain-related disability may impair the response to conservative TMD treatment.
The aim of the study was to compare the Finnish versions of the RDC/TMD and DC/TMD Axis II instruments and to evaluate their internal reliability. The study also compared the applicability of Graded Chronic Pain Scale (GCPS 1.0 in RDC/TMD-FIN vs. 2.0 in DC/TMD-FIN) pain intensity/interference assessments for biopsychosocial subtyping of TMD pain patients. The aim was also to evaluate the association of pain-related intensity/interference with the outcome of conservative treatment of TMD.
The first study sample included 197 TMD pain patients from Finnish university hospitals. The patients filled in DC/TMD-FIN and RDC/TMD-FIN Axis II questionnaires and questionnaires with additional pain-related, biopsychosocial and treatment-related variables. The patients were clinically examined based on DC/TMD Axis I protocol. They were categorized into TMD subtypes 1–3 according to GCPS 1.0 and 2.0. In another study sample, 80 TMD pain patients in tertiary care were categorized into TMD subtypes 1–3 based on GCPS 1.0 at baseline. Patients were treated conservatively. At follow-up visits during 1 year they evaluated their pain intensity and described the treatment outcome and TMD symptom severity.
The DC/TMD and RDC/TMD Axis II psychosocial instruments showed significant correlation and high internal reliability and internal inter-item consistency. Patients in TMD subtype 3 had biopsychosocial symptoms and reported previous healthcare visits significantly more often than the others. In the follow-up study, patients with TMD subtype 3 described their symptoms as most severe at each follow-up.
The Finnish versions of the DC/TMD Axis II psychosocial instruments show high validity and internal consistency and are thus applicable to Finnish TMD pain patients in tertiary care. GCPS 2.0 is suitable for categorizing tertiary care TMD pain patients into biopsychosocially relevant subtypes. Moderate/severe pain-related disability may impair the response to conservative TMD treatment.
Last updated: 23.1.2024