Influence of a Diagnosis of Depression and/or Anxiety on Temporomandibular Joint Treatment - A Retrospective Study

This cross-sectional retrospective study aimed to assess the depression and/or anxiety influence on temporomandibular disorders (TMD) diagnosis and treatment. The primary outcome was temporomandibular joint pain (VAS). The secondary outcomes were: 1) Health-related quality of life (VASLife);2) Maximal Mouth Opening (MMO);3) Myalgia degree. Patients were screened through PHQ-2 (depression) and GAD-2 (anxiety) validated questionnaires. A total of 247 patients (202 female), mean age of 40.51 ± 17.04, were enrolled. 133 patients (53.8%, GAD-2 ≥3) and 91 patients (38.4%, PHQ-2 ≥ 2) were screened positive for anxiety and depression, respectively.The mean pre-treatment pain was 4.25 ± 2.62; VASLife was 6.60 ± 2.36; MMO 37.15 ± 9.50; myalgia degree was 2.22 ± 0.99.A higher psychological distress burden was significantly correlated with VASLife (p=0.040, PHQ-2 ≥ 2; p=0.025, GAD-2 ≥3) and myalgia levels (p=0.013, PHQ-2 ≥ 2; p=0.038, GAD-2 ≥3). Myalgia significantly subsisted post-treatment in patients with anxiety (p=0.038, GAD-2 ≥3). The pre-treatment VASLife (OR=1.67; p=0.008) and, in anxious patients, post-treatment myalgia degree (OR=1.89; p<0.001) were determinant factors for reintervention. Depression and/ or anxiety were correlated to poor clinical outcomes, particularly in myogenous TMD. To implement multidisciplinary treatment programs for patients reporting a higher disease burden and refractory symptoms, awareness should be raised.