Emotional aspects of chronic orofacial pain and surgical treatment (original) (raw)
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PSYCHOLOGICAL FACTORS ASSOCIATED WITH CHRONIC OROFACIAL PAIN
Pain is one of the most common symptoms encountered in clinical practice and the head is a frequent site of pain. Chronic Orofacial Pain (COP) represents a complex pain condition with an etiology comprised of many factors including those falling within biological, psychological, and social domains. Psychogenic regional pain is a term used for "pain that patients feel in a region of the body where no peripheral cause can be found and is psychogenic in its evocation". Even in the field of psychology/psychiatry, many aetiologies and psychodynamics have been related to the development of psychogenic pain. This article deals with the treatment modalities to deal with the psychological repercussions of physical, orofacial pain. .
Psychological morbidity in chronic orofacial pain and headaches
AimsThe study aims to investigate the levels of anxiety and depression in patients experiencing orofacial pain and to explore similarities in psychological morbidity between patients experiencing chronic orofacial pain and those with chronic daily headaches. The study also aims to gain insight into the interference with functionality in chronic orofacial pain patients.The study aims to investigate the levels of anxiety and depression in patients experiencing orofacial pain and to explore similarities in psychological morbidity between patients experiencing chronic orofacial pain and those with chronic daily headaches. The study also aims to gain insight into the interference with functionality in chronic orofacial pain patients.Materials and methodsThe sample consisted of 150 new patients with chronic orofacial pain, 112 female and 38 male. Patients completed a retrospective facial pain questionnaire that included the Hospital Anxiety and Depression Scale (HADS), as well as the Brie...
Beliefs and distress about orofacial pain: patient journey through a specialist pain consultation
Journal of oral & facial pain and headache, 2014
To explore patients' understanding of their orofacial pain, as this is an under-researched area despite emerging as a common aim of consultation. Twelve people with chronic orofacial pain were interviewed shortly before their first consultation at a specialist facial pain clinic about their understanding of their pain, and they completed self-report measures of distress and pain interference. A day after the consultation, they wrote a short letter about how they now understood their pain and were then interviewed by phone. All accounts were analyzed using thematic analysis. Four themes emerged across preconsultation and postconsultation data: the need for information to counteract helplessness; worry as part of making sense of pain; validation of the pain experience (all predominant preconsultation); and the importance of trust (reflecting changes in understanding since consultation). Most patients changed their understanding of pain and resolved their worries to some extent, an...
Anxiety Assessment in Orofacial Pain Patients
2021
Objectives The aim of the present study was to assess the anxiety level in patients with orofacial pain and to compare it with patients without any orofacial pain. Methods The survey-based study was conducted that included a total of 100 patients who were divided into two groups: 50 patients with orofacial pain and 50 patients without pain. Questionnaire in a local language, that is, Marathi, was formulated based on Modified Dental Anxiety Scale (MDAS) and Hospital Anxiety and Depression Scale (HADS). Data was then subsequently collected and evaluated according to the score of MDAS and HADS. Results A total of 78 patients were evaluated according to the questionnaire survey. Highly significant correlation was found between anxiety level and pain present in patient on the MDAS-anxiety level scale(p = 0.001). Also, a significant correlation was observed between anxiety level and pain present in patient on the HADS-anxiety level (p = 0.007). A significant correlation was found between ...
European Journal of Pain, 2010
In our study, we investigated the predictive value of illness beliefs as measured by the revised illness perception questionnaire (IPQ-R) in the context of other clinical predictors in patients with chronic orofacial pain over a 6-month follow-up period. Consecutive patients (152) referred to the interdisciplinary orofacial pain service at the Centre for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zurich received questionnaires to assess pain and pain-related disability, anxiety, depression as well as physical and mental quality of life at three time points: prior to treatment, 3 and 6 months after beginning of treatment. Results: significant improvement was found over time for all outcome measures except mental quality of life. Results of the regression analysis indicated that believing pain could have serious consequences on one's life (IPQ subscale consequences) is one of the most important predictors for treatment outcome. The belief in low personal control and in a chronic timeline is also shown to be predictive for outcome, though explaining a smaller proportion of variance. These results provided evidence that beliefs about pain are important predictors for treatment outcome even when controlled for pain and mood. They therefore need to be considered in the management of patients with chronic orofacial pain. Assessing patients' illness beliefs can provide essential information on these important psychological determinants of adjustment to chronic pain and may be specific targets for individualised treatment approaches.
Journal of Pain Research
Chronic orofacial pain is prevalent and debilitating. Psychological and social factors place a heavy burden on this population but are often overlooked. Here, we offer the first comprehensive qualitative conceptualization of the challenges of living with chronic orofacial pain through a biopsychosocial perspective to inform multifaceted care for this population. Design: We employed a qualitative thematic analysis of open text responses using a hybrid inductive-deductive approach and a biopsychosocial framework. Methods: Two hundred and sixty participants with chronic orofacial pain responded to an open-ended question: "What is the biggest challenge you face in managing your condition?" by typing their responses into a text box as part of an online survey. We mapped responses onto biomedical, psychological, and social themes (deductive) and concurrently identified findings within each theme that emerged directly from the data (inductive). Results: Subthemes within the biomedical theme included challenges with biomedical pain management, medication side effects, sensory triggers, physical symptoms of stress/tension, and biological functions and related activities of daily living. Subthemes within the psychological theme included anxiety, depression, emotional symptoms of stress, unpredictability/uncertainty of pain, and psychological and cognitive aspects of medication management. Subthemes within the social theme included social relational, experience with providers, socioeconomics and access to care, and roles and responsibilities. Conclusion: Chronic orofacial pain is associated with multifaceted challenges. Consideration of individuals' experiences of biomedical, psychological, and social challenges in the assessment, referral, and treatment of chronic orofacial pain holds the potential to promote more comprehensive, patient-centered care for this population.
Chronic orofacial pain, cognitive‐emotional‐motivational considerations: A narrative review
Journal of Oral Rehabilitation, 2019
The following material was presented to an esteemed group of colleagues, Chinese physicians and stomotologists, friends and fellow panelists from around the globe at the Core China Conference, Nanjing China. Modern medicine accepts that a dichotomy exists between the mind, psyche and emotions and the rest of the body as if they function independently, having little downward up upward influence, one on the other. However, history teaches a different lesson. The influence of the emotional state of the patient plays a significant role effecting hormonal, neuroimmunological and peripheral modulatory factors influencing the pain experience. This brief discussion reviews the roots of modern Western Medicine in Traditional Chinese Medicine, and how we have come back to the realization of the mind-body concept in treating the patient as a single entity and not as a collection of systems.
Pain, 2010
Due to the cross-sectional nature of previous studies, whether mechanical factors predict the onset of Chronic oro-facial pain remains unclear. Aims of the current study were to test the hypotheses that self-reported mechanical factors would predict onset of Chronic oro-facial pain and that any observed relationship would be independent of the confounding effects of psychosocial factors and reporting of other unexplained symptoms. About 1735 subjects who had completed a baseline questionnaire were assessed at 2 year follow-up for the presence of Chronic oro-facial pain, psychosocial factors (anxiety and depression, illness behaviour, life stressors and reporting of somatic symptoms), mechanical dysfunction (facial trauma, grinding, phantom bite and missing teeth) and reporting of other unexplained symptoms (chronic widespread pain, irritable bowel syndrome and chronic fatigue). About 1329 subjects returned completed questionnaires (adjusted response rate 87%). About 56 (5%) reported new episodes of Chronic oro-facial pain at follow-up. Univariate analyses showed that age, gender, reporting of other unexplained symptoms, psychosocial factors and two self-report mechanical factors predicted the onset of Chronic oro-facial pain. However multivariate analysis showed that mechanical factors did not independently predict onset. The strongest predictors were health anxiety (Relative Risk (RR) 2.8, 95% CI 1.3–6.2), chronic widespread pain (RR 4.0 95% C.I. 2.2–7.4) and age (RR 0.2, 95% CI 0.1–0.7). The findings from this prospective study support the hypothesis that psychosocial factors are markers for onset of Chronic oro-facial pain. The efficacy of early psychological management of Chronic oro-facial pain to address these factors should be a priority for future investigations.
Psychological evaluation and cope with trigeminal neuralgia and temporomandibular disorder
Arquivos De Neuro-psiquiatria, 2008
OBJECTIVE: To determine the psychological aspects of orofacial pain in trigeminal neuralgia (TN) and temporomandibular disorder (TMD), and associated factors of coping as limitations in daily activities and feelings about the treatment and about the pain. METHOD: 30 patients were evaluated (15 with TN and 15 with TMD) using a semi-directed interview and the Hospital Anxiety Depression (HAD) scale. RESULTS: TN patients knew more about their diagnosis (p<0.001). Most of the patients with TN considered their disease severe (87%), in opposite to TMD (p=0.004); both groups had a high level of limitations in daily activities, and the most helpful factors to overcome pain were the proposed treatment followed by religiosity (p<0.04). Means of HAD scores were 10.9 for anxiety (moderate) and 11.67 for depression (mild), and were not statistically different between TMD and NT (p=0.20). CONCLUSION: TN and TMD had similar scores of anxiety and depression, therefore patients consider TN mor...