title: Perceived symptoms of psychological distress and salivary cortisol levels in young women with muscular or disk-related temporomandibular disorders.
abstract: OBJECTIVE
  To assess any differences in psychological and endocrine variables between homogeneous core groups of young women with well-defined muscle- or disk-related temporomandibular disorders (TMDs) and matched controls.
  
  
  METHODS
  Fifteen women, aged 18-24 years, fulfilling the TMD Research Diagnostic Criteria I a/b (but not II or III) and 15 fulfilling the II a/b and III criteria were consecutively selected from referrals to an orofacial pain/TMD clinic. Thirty consecutive healthy age-matched women attending yearly routine check-ups at a general dental clinic served as controls. All 60 subjects answered a questionnaire, the Profile of Fatigue Related Symptoms (PFRS), and salivary samples on waking were collected for analysis of cortisol levels.
  
  
  RESULTS
  Symptom duration and pain levels were similar irrespective of muscle- or disk-related symptoms. Both diagnostic groups obtained scores that were similar and significantly higher than those of controls in all four scales of the PFRS: fatigue, emotional distress, cognitive difficulties and somatic symptoms. Salivary cortisol levels on waking did not differ between patients and controls.
  
  
  CONCLUSIONS
  Patients with TMDs, irrespective of diagnosis, appeared to be more psychologically distressed than controls evaluated psychometrically, which is in line with earlier findings. A corresponding difference was not reflected in a single measurement of morning salivary cortisol. A more comprehensive evaluation of endocrine variables is probably necessary to reveal whether any differences actually exist in this respect.
authors.affiliation: Department of Prosthetic Dentistry, Specialist Center Uddevalla Hospital, Uddevalla, Sweden. annmarie.i.nilsson@vgregion.se
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Nilsson
authors.forename: Lars
authors.initials: L
authors.lastname: Dahlström
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000378:metabolism / Q000523:psychology; D005221:Fatigue / Q000378:metabolism / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008410:Masticatory Muscles / Q000503:physiopathology*; D010147:Pain Measurement; D012463:Saliva / Q000737:chemistry*; D013001:Somatoform Disorders / Q000378:metabolism / Q000523:psychology; D013315:Stress, Psychological / Q000378:metabolism / Q000523:psychology*; D019224:Temporomandibular Joint Disc / Q000503:physiopathology*; D013705:Temporomandibular Joint Disorders / Q000378:metabolism / Q000523:psychology*; D055815:Young Adult
chemical_list: D006854:Hydrocortisone