Evolución de la ansiedad, depresión y factores psicopatológicos en pacientes con trastornos temporomandibularesdiseño de un protocolo multidisciplinar

Abstract

ABSTRACT By means of a multidisciplinary protocol that includes areas of odontology, psychology, and physical therapy, a population of 64 patients of the division for Temporomandibular Disorders (TMD) at the Dental Clinic of the University of Murcia have been studied. The patients were diagnosed by a dentist and referred to be treated while their muscular and psychological development was followed up, and from this starting point identify the relationship between pain tolerances in ATM muscles and psychological variables expressed in terms of personality factors, anxiety as state-trait and psychopathological symptoms. Objectives " To identify the existent relation between TMD and psychological profiles and at the same time to study treatment evolution in relation to the patient's psychological state. " To establish the relationship between the patient's character and personality changes with TMD. " To evaluate treatment evolution of disorders, anxiety and psychological factors when physical therapy was the direct treatment. " To assess treatment outcomes in relation to the patient's psychological state. Methodology It was realized a quantitative, longitudinal, quasi-experimental of temporary series, where the initial variables were reviewed with a quantitative, cross-sectional and complemented with a correlation analysis. In terms of the odontology protocol, it was included the anamnesis with references to patients' clinical history, exploration and supplemental test. About the psychological aspects, a protocol was designed including a cognitive-behavioral treatment for TMD patients, applied by a psychology in 5 sessions. Next, it was realized an evaluation of the personality factors using the Cattell's 16PF, the Derogatis SCL-90R, and the Spielberger's State-Trait Anxiety Inventory. Regarding the physical therapy, the treatment applied was the Craniosacral Therapy, in which in five sessions, the physical therapist lightly palpates the patient's body, and focuses intently on the communicated movements, relocating the areas related to the TMD. Conclussions. 1. The personality profile of the patient diagnosed by TMD is related to one person with open mind, sensitive, apprehensive, stressed and with a huge component of anxiety and extroversion and with high dependency. 2. There is a positive correlation in TMD patients between personality factors such as O(Apprehension) with L(Vigilance), L(Vigilance) with E(Dominance) and H(Social Boldness) with E(Dominance); and a negative correlation between O(Apprehension) with C(Emotional Stability). 3. There is a negative correlation between Q4 (Tension) and headaches. More Tension implies less probability of headaches. 4. Patients with TMD tended to show a statistically significant improvement because of the multidisciplinary treatment as shown in the psychological symptoms' questionnaire SCL90R. 5. State-Trait Anxiety in patients with TMD shows cyclic-behavior during the treatment application. 6. There is a positive correlation in terms of pain tolerance of the TMD muscles. 7. There is an improvement in terms of pain tolerance of the TMD muscles at the end of the treatment.