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.