Catastrophizing is associated with pain-related disability in temporomandibular disorders

SOUSA, Cintia Regina Andrade; ARSATI, Ynara Bosco de Oliveira Lima; VELLY, Ana Miriam; SILVA, Carlos Alberto Lima da; ARSATI, Franco

doi:10.1590/1807-3107bor-2023.vol37.0070

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Original Research, Temporomandibular Joint Dysfunction • Braz. oral. res. 37 • 2023 • https://doi.org/10.1590/1807-3107bor-2023.vol37.0070 copy

Catastrophizing is associated with pain-related disability in temporomandibular disorders

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to evaluate the association of pain-related disability with biopsychosocial factors in temporomandibular disorders (TMD) patients. The study was carried out at the Orofacial Pain Outpatient Clinic of the State University of Feira de Santana, Bahia, from September 2018 to March 2020. The sociodemographic aspects, TMD subtypes, presence of pain-induced disability, pressure pain threshold, perceived stress, anxiety, depression, and catastrophizing were evaluated in 61 patients. The studied variables were compared between patients with and without pain-induced disability. Crude and adjusted logistic regression were performed to obtain estimates of odds ratios (OR) and 95% confidence intervals. With the exception of catastrophizing, there was no association between the biopsychosocial factors and pain-induced disability. The presence of catastrophizing increased the chance of having chronic pain-induced disability by 4.02 times. The results of this study indicate a strong association between pain catastrophizing and disability in individuals with chronic painful TMD.

Temporomandibular Joint Disorders; Catastrophization; Chronic Pain

Graded chronic pain scale	Groups	n	%
No-Disability Group
Low-intensity pain without disability	I	12	19.7
High-intensity pain without disability	II	21	34.4
Disability Group
High-intensity pain with moderately limiting disability	III	13	21.3
High-intensity pain with severely limiting disability	IV	15	24.6
Total		61	100.0

Sociodemographic aspects	No-disability group		Disability group		p-value

	n = 33	%	n = 28	%
Sex
Male	6	18.2	2	7.1	0.269
Female	27	81.8	26	92.9
Marital status
Married	12	36.4	13	46.4
Single	20	60.6	12	42.9	0.275
Widower	1	3.0	1	3.6	0.957
Separated / Divorced	0	0.0	2	7.1
Education
Primary	4	12.1	3	10.7
Middle school	16	48.5	17	60.7	0.678
College	12	36.4	6	21.4	0.657
Master’s / Doctorate	1	3.0	2	7.1	0.497
Labor activity^a
Yes	13	39.4	13	48.1	0.496
No	20	60.6	14	51.9
Income^a
Less than 1 salary	7	21.2	4	14.8
Between 1 and 3 salaries	19	57.6	18	66.7	0.475
More than 3 salaries	7	21.2	5	18.5	0.795

Variable	No-disability group	Disability group	p-value
Right masseter ^a	1.2 [1.0–1.6]	1.0 [0.7–1.4]	0.148 ^c
Left masseter ^a	1.3 [0.9–1.7]	1.0 [1.0–1.3]	0.085 ^c
Right forearm ^a	2.8 [2.3–3.6]	2.7 [2.0–3.4]	0.258 ^c
Right temporal ^b	1.78 ± 0.61	1.46 ± 0.62	0.052 ^d
Left temporal ^b	1.61 ± 0.59	1.44 ± 0.62	0.288 ^d

Psychological aspects	No-disability		Disability		p-value	95%CI

	n = 33	%	n = 28	%
Depression
Yes	23	69.7	22	78.6	0.432	0.50–5.13
No	10	30.3	6	21.4
Anxiety
Yes	29	87.9	25	89.3	1	0.23–5.63
No	4	12.1	3	10.7
Catastrophizing
Yes	8	24.2	16	57.1	0.009	1.40–12.43
No	25	75.8	12	42.9
Catastrophizing (subscales)
Rumination
Yes	9	30.0	21	70.0	<0.001	2.54–25.22
No	24	77.4	7	22.6
Amplification
Yes	19	45.2	23	54.8	0.044	1.03–11.12
No	14	73.7	5	26.3
Helplessness
Yes	7	29.2	17	70.8	0.002	1.86–17.73
No	26	70.3	11	29.7

Disability	OR	95%CI	p-value	OR_a	95%CI	p- value
Sex
Male	1 (reference)			-	-	-
Female	2.89	0.53–15.63	0.218
Neck pain
No	1 (reference)			-	-	-
Yes	2.30	0.69–7.70	0.177
Headache
No	1 (reference)			1 (reference)
Yes	4.16	0.80–21.53	0.089	3.40	0.60–19.19	0.166
Diagnosis
Muscular	1 (reference)			1 (reference)
Mixed	0.68	0.41–1.14	0.144	0.57	0.32–1.02	0.060
Depression
No	1 (reference)			-	-	-
Yes	1.59	0.50–5.13	0.434
Catastrophizing
No	1 (reference)			1 (reference)
Yes	4.17	1.40–12.43	0.010	4.02	1.22–13.26	0.022

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[1] Corresponding Author: Cintia Regina Andrade Sousa E-mail: crasousa@uefs.br