Psychophysical subtypes of temporomandibular disorders

This study presents an approach to the classification of temporomandibular disorders (TMD) based on acknowledgement of the interaction of physical, psychologic, and social factors using a multidimensional instrument that has been previously validated. The psychometric properties of this instrument were reevaluated in 140 women with TMD. Multidimensional clustering identified three subgroups of patients with TMD, including a highly distressed, psychosocially maladaptive group; a moderately distressed, behaviorally functional group; and a predominantly physical disorder group with an unremarkable psychosocial profile. These groups were termed maladaptive, adaptive, and uncomplicated, respectively, according to the constellation of predominant symptoms and psychosocial profiles of each cluster. The groups showed no consistent differences in pain frequency, use of medication, or duration of pain. This finding supports earlier work that suggested the prominence of three subtypes of this disorder according to both physical illness and psychosocial illness impact parameters.