Temporomandibular disorders: Part II. A comparison of psychologic profiles in Australian and Finnish patients

Recent recommendations regard musculoskeletal disorders of the masticatory system as dual-axis disorders, but little comparative data of psychologic factors across different pain populations are available. In this study, presenting psychologic profiles were assessed in 40 Australian and 42 Finnish patients diagnosed with temporomandibular disorders. Findings were compared with those of a group of Australian patients reporting acute dental pain and with reference to response to conservative management. The psychologic testing instrument incorporated cognitive, motivational/affective, and illness behavior variables, and it was based on validated general pain questionnaires (Coping Strategies Questionnaire and Illness Behavior Questionnaire). This instrument was found internally reliable in the majority of its subscales in the group studies and provided comparable data to other pain populations. Significant differences in the presenting psychologic profiles were found according to nationality, type of pain suffered, and treatment outcome. Affective disturbance, hypochondriasis, lack of cognitive control, and feeling ill with symptoms were identified in discriminant function analysis as potential predictors of treatment outcome, and they correctly classified 79% of the Australian and 87% of the Finnish patients with temporomandibular disorders. It was concluded that psychologic profiles differed in the two nationalities and were related to treatment outcome. The concept of multiaxial assessment was supported.