title: Psychological profile and self-administered relaxation in patients with craniofacial pain: a prospective in-office study.
abstract: BACKGROUND
  The objective of this study was to evaluate the psychological profile of craniofacial pain sufferers and the impact of patient subtype classification on the short-time effectiveness of a self-administered relaxation training.
  
  
  METHODS
  One hundred unselected in-office patients (67% females) suffering from chronic facial pain and/or headache with the presumptive diagnose of temporo-mandibular disorder (TMD) completed a questionnaire battery comprising craniofacial pain perception, somatic complaints, irrational beliefs, and pain behavior and were classified into subtypes using cluster analysis. They underwent a self-administered progressive relaxation training and were re-evaluated for pain perception after 3 months.
  
  
  RESULTS
  Pain was mild to moderate in the majority of patients. Symptom domains comprised parafunctional activities, temporo-mandibular pain and dysfunction, fronto-temporal headache, head/neck and neck/back pain. Three patient subtypes were identified regarding symptom/dysfunction level: (i) low burden (mild/moderate), (ii) psychosocial dysfunction (moderate/high), (iii) adaptive coping (moderate/mild). Self-rated adherence to the recommended relaxation training was moderate throughout the sample, but self-rated relief was significantly different between clusters. At follow-up, pain intensity was significantly decreased in all patients, whereas pain-related interference was improved only in dysfunctional and adaptive patients. Improvement of symptom domains varied between clusters and was most comprehensive in adaptive patients.
  
  
  CONCLUSIONS
  In conclusion, craniofacial pain sufferers can be divided in meaningful subtypes based on their pain perception, irrational beliefs, and pain behaviour. A self-administered relaxation training generally yielded positive effects on pain perception, however the benefit may be greater in patients with more marked symptom impact (both dysfunctional and adaptive).
authors.forename: Christian
authors.initials: C
authors.lastname: Kirschneck
authors.forename: Piero
authors.initials: P
authors.lastname: R Ömer
authors.forename: Peter
authors.initials: P
authors.lastname: Proff
authors.forename: Carsten
authors.initials: C
authors.lastname: Lippold
mesh_terms: D000328:Adult; D005157:Facial Pain / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058748:Pain Perception; D011446:Prospective Studies; D012064:Relaxation Therapy; D012648:Self Care; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000523:psychology