title: [Differential and common characteristics of patients with atypical facial pain and craniomandibular dysfunction].
abstract: BACKGROUND
  Craniomandibular disorders (CMD) and atypical facial pain (AFP) represent a clinical challenge. Whereas CMD patients respond to somatic approaches, somatization should be strictly avoided in AFP. The aim of this study was to establish prognostic criteria to identify an aggravated risk of a chronic course in CMD and AFP.
  
  
  METHODS
  A total of 124 consecutive patients with CMD ( n=108) or AFP ( n=16) were examined by two interdisciplinary academic pain centers. Psychometric evaluation was conducted with standardized questionnaires (SCL-90R, STAXI, modified SBAS-IV). All patients were clinically assessed by a maxillofacial surgeon or specialized dentist.
  
  
  RESULTS
  The following variables proved to be significant: age (risk for AFP vs CMD increased by 6% p.a.), decreased dysfunction index (13% higher risk for AFP vs CMD), and low scores concerning outwardly directed anger (12% higher risk for AFP vs CMD). There was no correlation between initial pain intensity and somatic parameters of disease as assessed by the standardized clinical examination. Low educational status proved to be the best predictor ( p<0.001) for patients presenting high initial pain with a marked discrepancy between somatic findings and subjective status.
  
  
  CONCLUSIONS
  CMD patients differ from AFP patients regarding age, psychosocial isolation, outwardly directed anger, and a decreased dysfunction index. Additionally, initial pain intensity in patients presenting indistinct CMD/AFP can be considered as a valid predictor for a chronic course in pain.
authors.affiliation: Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie, Klinikum rechts der Isar, Technische Universität München, Munich. A.Neff@lrz.tu-muenchen.de
authors.forename: A
authors.initials: A
authors.lastname: Neff
authors.forename: A
authors.initials: A
authors.lastname: Wolowski
authors.forename: P
authors.initials: P
authors.lastname: Scheutzel
authors.forename: A
authors.initials: A
authors.lastname: Kolk
authors.forename: K H
authors.initials: KH
authors.lastname: Ladwig
authors.forename: A
authors.initials: A
authors.lastname: Grübl
authors.forename: B
authors.initials: B
authors.lastname: Marten-Mittag
authors.forename: M
authors.initials: M
authors.lastname: Hammes
authors.forename: H-H
authors.initials: HH
authors.lastname: Horch
authors.forename: H
authors.initials: H
authors.lastname: Gündel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005156:Facial Neuralgia / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010555:Personality Inventory; D012307:Risk Factors; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology
vernacular_title: Differenzielle und gemeinsame Merkmale bei Patienten mit atypischem Gesichtsschmerz und kraniomandibularer Dysfunktion.