title: Is there an association between anxiety/depression and temporomandibular disorders in college students?
abstract: OBJECTIVE
  Considering the high incidence of Temporomandibular Disorders (TMD) in the population aged 15-30 years and the fact that students are exposed to stressful psychosocial factors, the purposes of this study were: to verify clinical symptoms and jaw functionality in college students with TMD according to the anxiety/depression (A/D) level and to evaluate the correlation between A/D and functionality, maximum mouth opening (MMO) and pain and muscle activity.
  
  
  METHODS
  Nineteen students with TMD diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders underwent two assessments during an academic semester. The evaluations were based on questionnaires (MFIQ - Mandibular Function Impairment Questionnaire; HADS - Hospital Anxiety and Depression Scale), clinical measurements (MMO without pain, MMO and assisted MMO; palpation of joint and masticatory muscles), and electromyography. The HADS scores obtained in the two assessments were used to classify all data as either "high" or "low" A/D. Data normality, differences and correlations were tested with the Shapiro-Wilk test, Student's t-test (or the Wilcoxon test), and Spearman test, respectively. The alpha level was set at 0.05.
  
  
  RESULTS
  None of the clinical variables were significantly different when comparing low and high A/D data. In low A/D there was a significant correlation between HADS score and: MFIQ (P=0.005, r=0.61), and MMO without pain (P=0.01, r=-0.55).
  
  
  CONCLUSIONS
  Variation in A/D level did not change clinical symptoms or jaw functionality in college students with TMD. Apparently, there is a correlation between TMJ functionality and A/D level, which should be further investigated, taking into account the source of the TMD and including subjects with greater functional limitation.
authors.affiliation: Federal University of São Carlos, Department of Physical Therapy, São CarlosSP, Brazil, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
authors.forename: Letícia Bojikian
authors.initials: LB
authors.lastname: Calixtre
authors.affiliation: Federal University of São Carlos, Department of Physical Therapy, São CarlosSP, Brazil, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
authors.forename: Bruno Leonardo da Silva
authors.initials: BL
authors.lastname: Grüninger
authors.affiliation: University of São Paulo, FMRP, Department of Neurosciences and Behavioral Sciences, Ribeirão PretoSP, Brazil, Department of Neurosciences and Behavioral Sciences, University of São Paulo (FMRP/USP), Ribeirão Preto, SP, Brazil.
authors.forename: Thais Cristina
authors.initials: TC
authors.lastname: Chaves
authors.affiliation: Federal University of São Carlos, Department of Physical Therapy, São CarlosSP, Brazil, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
authors.forename: Ana Beatriz de
authors.initials: AB
authors.lastname: Oliveira
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000503:physiopathology / Q000523:psychology*; D003863:Depression / Q000503:physiopathology / Q000523:psychology*; D004576:Electromyography; D004812:Epidemiologic Methods; D005157:Facial Pain / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008410:Masticatory Muscles / Q000503:physiopathology; D010147:Pain Measurement; D012016:Reference Values; D012720:Severity of Illness Index; D013334:Students / Q000523:psychology*; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult