The relationship of somatization and depression to experimental pain response in women with temporomandibular disorders.
OBJECTIVE
Patients with temporomandibular pain disorders (TMD) have greater experimental pain perception when compared with pain-free controls. Common psychological features of TMD include somatization and depression. The impact of depression on experimental pain perception has received considerable attention. However, the role of somatization on experimental pain in a chronic pain population has not been explored.


METHODS
Fifty-six women with TMD and 59 pain-free controls underwent three experimental pain procedures, including palpation at fixed amounts of pressure, pressure pain thresholds, and an ischemic pain task. Levels of depression and somatization were assessed using the Research Diagnostic Criteria for TMD. Multiple regression analyses were performed to determine the extent to which depression and somatization were associated with experimental pain response.


RESULTS
After controlling for characteristic pain intensity and depression, somatization explained a significant proportion of variance in numbers of masticatory sites rated as painful (R2 change = 6.7%, p = .046) with the full model explaining 16.4% of the variance (p = .024). This did not meet an adjusted level of statistical significance (p = .008). After controlling for characteristic pain, only depression added significantly to the model predicting ischemic pain threshold and tolerance. The full models including characteristic pain and depression explained 49% and 20% of the variance in ischemic pain threshold and tolerance, respectively.


CONCLUSIONS
These findings suggest that depression and somatization are associated with different measures of experimental pain. Somatization may be related to more attentional and perceptual measures of clinically relevant pain while depression may be related to more behavioral measures of pain.
Sherman
Jeffrey J
JJ
Department of Oral Medicine, University of Washington, Seattle, WA 98195-6370, USA. jeffreys@u.washington.edu
LeResche
Linda
L
Huggins
Kimberly Hanson
KH
Mancl
Lloyd A
LA
Sage
Julie C
JC
Dworkin
Samuel F
SF
D000293:Adolescent; D000328:Adult; D001132:Arm / Q000098:blood supply; D002908:Chronic Disease; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005157:Facial Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000523:psychology; D010146:Pain / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D017288:Pain Threshold; D010173:Palpation; D011312:Pressure; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012044:Regression Analysis; D013001:Somatoform Disorders / Q000453:epidemiology* / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology