Temporal relationship between dysthymia and temporomandibular disorder: a population-based matched case-control study in Taiwan.
BACKGROUND
Numerous studies have reported a relationship between depression and temporomandibular disorders (TMD), but the conclusions remain undefined. The aim of this article was to examine the temporal relationship between depression and TMD.


METHODS
In this retrospective matched case-control study, we recruited all samples from a randomsample sub-dataset of one million insured individuals for the year 2005 (Longitudinal Health Insurance Database (LHID2005)). All beneficiaries were enrolled in the National Health Insurance (NHI) programme in Taiwan. We used propensity scoring and matched the case and control groups (1:1) by ten confounding factors to detect the effect of different types of depression on TMD.


RESULTS
The positive correlative factors of TMD included the total number of times medical advice was sought for an unspecified anomaly of jaw size plus malocclusion (TTSMA-JS, p = 0.045), the total number of times medical advice was sought for an anxiety state (TTSMA-AS, p = 0.000), and the total number of times medical advice was sought for a panic disorder (TTSMA-P, p = 0.009). Dysthymia (synonymous with chronic depression) had an effect on TMD. The odds ratio (OR) of dysthymia for TMD measured by multiple logistic regression was 1.91 (p = 0.008) after adjusting for demographic factors, psychiatric comorbidities, and maxillofacial confounders.


CONCLUSIONS
This study demonstrated the established temporal relationship between dysthymia and TMD. The inclusion of a psychiatrist on the TMD management team is appropriate.
Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.|Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan.
Shang-Lun
SL
Lin
School of Medicine, Griffith University, Gold Coast, Australia.
Shang-Liang
SL
Wu
Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan.
Shun-Yao
SY
Ko
School of Dentistry, Taipei Medical University, Taipei, Taiwan.|Department of Oral and Maxillofacial Surgery, Chi-Mei Medical Center, Yongkang, Tainan, Taiwan.
Ching-Yu
CY
Yen
Department of Oral and Maxillofacial Surgery, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.|School of Dentistry, National Yang-Ming University, Taipei, Taiwan.
Wei-Fan
WF
Chiang
Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan. jungwuyang1979@gmail.com.|Department of Oral and Maxillofacial Surgery, Tainan Sin Lau Hospital, the Presbyterian Church in Taiwan, Tainan, Taiwan. jungwuyang1979@gmail.com.|Yuan Yuan Dental Federation, Tainan, Taiwan. jungwuyang1979@gmail.com.|, 701 No. 57, Sec. 1, East Gate Road, East Dist., Tainan City,, Taiwan, R.O.C.. jungwuyang1979@gmail.com.
Jung-Wu
JW
Yang
D016022:Case-Control Studies; D019263:Dysthymic Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D057216:Propensity Score; D012189:Retrospective Studies; D013624:Taiwan; D013705:Temporomandibular Joint Disorders / Q000523:psychology*; D013997:Time Factors