title: Research Diagnostic Criteria Axis II in screening and as a part of biopsychosocial subtyping of Finnish patients with temporomandibular disorder pain.
abstract: OBJECTIVE
  To assess Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II variables in an initial psychosocial screening and as a part of biopsychosocial subtyping of Finnish referral patients with TMD pain for adjunct multidisciplinary assessment.
  
  
  METHODS
  Consecutive Finnish referral patients with TMD pain (n = 135) participated in this questionnaire-based survey. Psychosocial screening was based on Graded Chronic Pain Scale (GCPS) and culturally adjusted Symptom Checklist 90-revised (SCL-90R) depression scale scores and subtyping on GCPS pain-related interference in accordance with previous treatment tailoring studies. Biopsychosocial subtyping variables included symptoms of depression and somatization, general health, pain-related worry, sleep dysfunction, and coping ability. Subtype comparisons were analyzed with Bonferroni adjusted P values and multivariable logistic regression (SAS 9.3).
  
  
  RESULTS
  Based on psychosocial screening, 44% of the patients were psychosocially uncompromised (TMD subtype 1), 33% moderately, and 23% severely compromised (TMD subtypes 2 and 3). Compared to TMD subtype 1, TMD subtype 2 patients reported intermediate scores, and the most vulnerable TMD subtype 3 had the poorest general health, most elevated depression, somatization, worry and sleep dysfunction, and poor coping ability (P < .05). According to multivariable logistic regression, depression and worry levels were significantly higher in TMD subtype 3 compared to TMD subtype 1, whilst patients in TMD subtypes 1 and 2 reported significantly better coping ability compared to TMD subtype 3 (P < .05).
  
  
  CONCLUSIONS
  The Finnish RDC/TMD Axis II was found reliable in initial TMD pain patient screening and with further biopsychosocial assessment identified three main TMD subtypes, two with compromised psychosocial profiles for adjunct multidisciplinary assessment.
authors.forename: Tuija I
authors.initials: TI
authors.lastname: Suvinen
authors.forename: Pentti
authors.initials: P
authors.lastname: Kemppainen
authors.forename: Yrsa
authors.initials: Y
authors.lastname: Le Bell
authors.forename: Anna
authors.initials: A
authors.lastname: Valjakka
authors.forename: Tero
authors.initials: T
authors.lastname: Vahlberg
authors.forename: Heli
authors.initials: H
authors.lastname: Forssell
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D016009:Chi-Square Distribution; D059350:Chronic Pain; D003863:Depression / Q000209:etiology; D005157:Facial Pain / Q000145:classification / Q000175:diagnosis / Q000209:etiology*; D005387:Finland; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010147:Pain Measurement; D010348:Patient Care Team; D011584:Psychology; D012893:Sleep Wake Disorders / Q000209:etiology; D013001:Somatoform Disorders / Q000209:etiology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000145:classification* / Q000150:complications* / Q000175:diagnosis