title: Temporomandibular dysfunction and risk factors for anxiety and depression.
abstract: BACKGROUND
  Anxiety and depression may cause temporomandibular joint (TMJ) complaints or TMJ disorders may trigger some of psychiatric problems.
  
  
  OBJECTIVE
  The aim of this study was to determine the risk factors and the interactive role of anxiety and depression in patients with TMJ dysfunction.
  
  
  METHODS
  A total of 273 patients who presented to the multidisciplinary outpatient clinic of TMJ diseases that were followed up for temporomandibular dysfunction (TMD), were included in this trial. Patients were classified in three sub-groups: patients with myofacial pain alone (group-1), patients with TMJ disorder alone (group-2), and patients with TMJ disorder and also myofacial pain (group-3). All patients were examined using the standard TMJ examination and were evaluated with the Hospital Anxiety Depression (HAD) scale in order to determine anxiety and depression.
  
  
  RESULTS
  According to the univariate analysis, risk factors for patients with confirmed anxiety and/or depression were being female (p= 0.005), existence of myofacial pain (p= 0.01), effects of stress on complaints (p= 0.005) and insufficient social support (p< 0.001). According to regression analysis, presence of psychopathology was increased 3.7 times in those being female, 3.5 times with insufficient social support, and 1.2 times with myofacial pain.
  
  
  CONCLUSIONS
  Among the patients with TMD, the groups who were considered to have anxiety and depression were female patients, patients with deficient social support system, and patients with myofacial pain alone or patients with myofacial pain accompanying an existing TMJ disorder. The existence of anxiety and depression should be considered in addition to musculoskeletal pathologies during the treatment plan of patients with TMJ who have these risk factors.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Unit of Temporomandibular Disorders, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Demirhan
authors.initials: D
authors.lastname: Dıraçoǧlu
authors.affiliation: Department of Consultation Liaison Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Nazmiye Kocaman
authors.initials: NK
authors.lastname: Yıldırım
authors.affiliation: Department of Physical Medicine and Rehabilitation, Unit of Temporomandibular Disorders, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: İlknur
authors.initials: İ
authors.lastname: Saral
authors.affiliation: Department of Consultation Liaison Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Mine
authors.initials: M
authors.lastname: Özkan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Unit of Temporomandibular Disorders, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Karan
authors.affiliation: Department of Consultation Liaison Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Özkan
authors.affiliation: Department of Physical Medicine and Rehabilitation, Unit of Temporomandibular Disorders, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Aksoy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D003863:Depression / Q000209:etiology*; D005157:Facial Pain / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012944:Social Support; D013705:Temporomandibular Joint Disorders / Q000523:psychology*; D055815:Young Adult
keywords: Temporomandibular dysfunction; anxiety; depression; risk factors