title: Anxiety and depression in adolescents and their relationship with signs and symptoms of temporomandibular disorders.
abstract: OBJECTIVE
  Several clinical studies suggest that psychologic factors may play an important role in the etiology and maintenance of temporomandibular disorder (TMD) signs and symptoms. The goal of this study was to verify the prevalence of anxiety and depression in adolescents, and their relationship with signs and symptoms of TMD.
  
  
  METHODS
  The sample comprised 217 nonpatient adolescents between 12 and 18 years of age. The subjective symptoms and clinical signs of TMD were evaluated, respectively, using a self-report questionnaire and the Craniomandibular Index (CMI, which has 2 subscales), the Dysfunction Index, and the Palpation Index. The Hospital Anxiety and Depression Scale (HADS), a 14-item self-administered rating scale that was developed specifically to identify anxiety and depression in nonpsychiatric medical outpatients, assessed levels of anxiety and depression.
  
  
  RESULTS
  In the total sample, anxiety and depression were present in 16.58% and 26.71% of subjects, respectively, including all levels of HADS. The results showed that there were positive correlations between CMI and Palpation Index and anxiety (HADSa) (P < .01) but not with depression (HADSd). An association between the number of TMD subjective symptoms and HADSa/HADSd was found (P < .01).
  
  
  CONCLUSIONS
  Anxiety and depression, although of mild intensity, are common in adolescents. In this study both HADSa and HADSd were associated with an increasing number of TMD subjective symptoms. However, only anxiety was correlated with clinical signs of TMD (CMI), primarily muscle tenderness (Palpation Index).
authors.affiliation: Department of Oral Physiology, Piracicaba Dental School, State University of Campinas (FOP/UNICAMP), Piracicaba, São Paulo, Brazil.
authors.forename: Leonardo Rigoldi
authors.initials: LR
authors.lastname: Bonjardim
authors.forename: Maria Beatriz Duarte
authors.initials: MB
authors.lastname: Gavião
authors.forename: Luciano José
authors.initials: LJ
authors.lastname: Pereira
authors.forename: Paula Midori
authors.initials: PM
authors.lastname: Castelo
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000150:complications*; D016009:Chi-Square Distribution; D002648:Child; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008347:Manifest Anxiety Scale; D010173:Palpation; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000150:complications* / Q000523:psychology*