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Preliminary Psychologic Survey of Orofacial Outpatients. Part 1: Predictors of Anxiety or Depression

  • Koji Kino1,*,
  • Masashi Sugisaki2
  • Takayuki Ishikawa3
  • Tomoaki Shibuya3
  • Teruo Amagasa3
  • Hitoshi Miyaoka4

1Temporomandibular Joint Clinic, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan

2Department of Dentistry, Jikei University School of Medicine, Tokyo, Japan

3Maxillofacial Surgery, Maxillofacial, Reconstruction and Function, Division of Maxillofacial and Neck Reconstruction, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan

4Department of Psychiatry, Kitasato University of Medicine, Sagamihara, Japan

DOI: 10.11607/jofph.15305 Vol.15,Issue 3,September 2001 pp.235-244

Published: 30 September 2001

*Corresponding Author(s): Koji Kino E-mail: k-kino.mfs@tmd.ac.jp

Abstract

Aims: To identify predictors for anxiety and depression in orofacial outpatients and to investigate the patients’ compliance rate in taking a series of psychologic tests. Methods: Three thousand six hundred sixty-six patients completed a battery of questionnaires. These consisted of items inquiring about sex, age, past history of disease, presence of pain, the Hospital Anxiety and Depression Scale (HADS), the Eysenck Personality Questionnaire Short Form (S-EPQ), a Japanese dental version of the McGill Pain Questionnaire (JDMPQ), a visual analog scale (VAS) of pain, pain duration, and diagnosis. After univariate analyses had determined those variables with significant differences between an over-probable group (OPG, HADS scores ≥ 8) and an absent group (AG, HADS scores < 8), we estimated the odds ratios of these variables for OPG as independent variables, and every variable was adjusted between the independent variables by multiple logistic regression models. Results: For anxiety, 3 variables were independently related to the OPG and considered to be meaningful: age 30 or older, neuroticism score on the S-EPQ, and selection of the JDMPQ pain expression term “sickening.” For depression, 4 variables were independently related to the OPG and considered to be meaningful: age 30 or older, neuroticism and extroversion scores on the S-EPQ, and selection of the JDMPQ pain expression term “sickening.” The compliance rate for the tests was under half of the patients (3,666 of 7,542 patients). Conclusion: Although the predictability for anxiety or depression by some baseline parameters is considered to be low, age, personality traits, and choice of certain pain expression terms are useful predictors of anxiety or depression. The improvement of the compliance rate for psychologic screening will be a future challenge for Japanese clinics managing orofacial patients.

Keywords

questionnaires; anxiety; depression; predictor; logistic model; regression analysis

Cite and Share

Koji Kino,Masashi Sugisaki,Takayuki Ishikawa,Tomoaki Shibuya,Teruo Amagasa,Hitoshi Miyaoka. Preliminary Psychologic Survey of Orofacial Outpatients. Part 1: Predictors of Anxiety or Depression. Journal of Oral & Facial Pain and Headache. 2001. 15(3);235-244.

References

1. Gershon ES, Hamovit JH, Guroff JJ, Nurnberger JI. Birth-cohort changes in manic and depressive disorders in relatives of bipolar and schizoaffective patients. Arch Gen Psychiatry 1987;44(4):314–319.

2. Nakamura Y, Ojima T, Oki I, Tanihara S, Yanagawa H. Estimation of the future numbers of patients with mental disorders in Japan based on the results of National Patient Surveys. J Epidemiol 1997;7(4):214–220.

3. Spitzer RL, Williams JB, Kroenke K, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994;272(22): 1749–1756.

4. Nielsen AC III, Williams TA. Prevalence by self-report questionnaire and recognition by nonpsychiatric physicians. Arch Gen Psychiatry 1980;37(9):999–1004.

5. Freeling P, Rao BM, Paykel ES, Sireling LI, Burton RH. Unrecognised depression in general practice. Br Med J (Clin Res Ed) 1985;290(6485):1880–1883.

6. Wilkinson MJ, Barczak P. Psychiatric screening in general practice: Comparison of the general health questionnaire and thehospital anxiety depression scale. R Coll Gen Pract 1988;38(312):311–313.

7. Oakley ME, McCreary CP, Flack VF, Clark GT, Solberg WK, Pullinger AG. Dentists’ ability to detect psychological problems in patients with temporomandibular disorders and chronic pain. J Am Dent Assoc 1989;118(6):727–730.

8. Hughes AM, Hunter S, Still D, Lamey PJ. Psychiatric disorders in a dental clinic. Br Dent J 1989;166:16–19.

9. Schwartz RA, Greene CS, Laskin DM. Personality characteristics of patients with myofascial pain-dysfunction (MPD) syndrome unresponsive to conventional therapy. J Dent Res 1979;58(5):1435–1439.

10. Greene CS, Olson RE, Laskin DM. Psychological factors in the etiology, progression, and treatment of MPD syndrome. J AmDent Assoc 1982;105(3):443–448.

11. Feinmann C, Harris M. Psychogenic facial pain. Part 2: Management and prognosis. Br Dent J 1984; 156:205–208.

12. Delaney JF. Atypical facial pain as a defence against psychosis. Am J Psychiatry 1976;133:1151–1154.

13. Morris S, Benjamin S, Gray R, Bennett D. Physical, psychiatric and social characteristics of the temporomandibular disorder pain dysfunction syndrome: The relationship of mental disorders to presentation. Br Dent J 1997;182(7):255–260.

14. Kinney RK, Gatchel RJ, Ellis E, Holt C. Major psychological disorders in chronic TMD patients: Implications for successful management. J Am Dent Assoc 1992; 123:49–54.

15. Lamey PJ, Lamb AB. The usefulness of the HAD scale in assessing anxiety and depression in patients with burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1989;67(4):390–392.

16. Paterson AJ, Lamb AB, Clifford TJ, Lamey PJ. Burning mouth syndrome: The relationship between the HAD scale and parafunctional habits. J Oral Pathol Med 1995;24(7):289–292.

17. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67(6):361–370.

18. Eysenck HJ. A short questionnaire for the measurement of two dimensions of personality. J Appl Psychiatry 1958;42(1):14–17.

19. Kino K, Sugisaki M, Ito H, et al. Multi-dimensional evaluation of pain in oral and maxillofacial diseases and examination of expression terms of pain using Japanese McGill Pain Questionnaire [in Japanese]. J Jpn Stomatol Soc 1997;46(4):444–456.

20. Hamer D, Sanjeev D, Butterworth E, Barczak P. Using the Hospital Anxiety and Depression Scale to screen for psychiatric disorders in people presenting with deliberate self-harm. Br J Psychiatry 1991;158:782–784.

21. Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, Van Hemert AM. A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 1997;27(2):363–370.

22. Johnson G, Burvill PW, Anderson CS, Jamrozik K, Stewart-Wynne EG, Chakera TM. Screening instruments for depression and anxiety following stroke: Experience in the Perth community stroke study. Acta Psychiatr Scand 1995;91(4):252–257.

23. Janson C, Bjornsson E, Hetta J, Boman G. Anxiety and depression in relation to respiratory symptoms and asthma. Am J Respir Crit Care Med 1994;149:930–934.

24. Chandarana PC, Eals M, Steingart AB, Bellamy N, Allen

S. The detection of psychiatric morbidity and associated factors in patients with rheumatoid arthritis. Can J Psychiatry 1987;32(5):356–361.

25. Hopwood P, Howell A, Maguire P. Screening for psychiatric morbidity in patients with advanced breast cancer: Validation of two self-report questionnaires. Br J Cancer 1991;64(2):353–356.

26. Razavi D, Delvaux N, Bredart A, et al. Screening for psychiatric disorders in a lymphoma out-patient population. Eur J Cancer 1992;28A(11):1869–1872.

27. Carroll BT, Kathol RG, Noyes R Jr, Wald TG, Clamon GH. Screening for depression and anxiety in cancer patients using the Hospital Anxiety and Depression Scale. Gen Hosp Psychiatry 1993;15(2):69–74.

28. Ibbotson T, Maguire P, Selby P, Priestman T, Wallace L. Screening for anxiety and depression in cancer patients: The effectsof disease and treatment. Eur J Cancer 1994;30A(1):37–40.

29. Aass N, Fossa SD, Dahl AA, Moe TJ. Prevalence of anxiety and depression in cancer patients seen at the Norwegian Radium Hospital. Eur J Cancer 1997;33(10):1597–1604.

30. Loge JH, Abrahamsen AF, Ekeberg O, Hannisdal E, Kaasa S. Psychological distress after cancer cure: A survey of 459 Hodgkin’s disease survivors. Br J Cancer 1997;76(6):791–796.

31. Zatrzewska JM, Feinmann C. A standard way to measure pain and psychological morbidity in dental practice. Br Dent J 1990;24:337–339.

32. Telfer MR, Shepherd JP. Psychological distress in patients attending an oncology clinic after definitive treatment for maxillofacial malignant neoplasia. Int J Oral Maxillofac Surg 1993;22:347–349.

33. Hatta H, Higashi A, Yashiro H, et al. A validation of the Hospital Anxiety and Depression Scale [in Japanese]. Jpn J Psychosom Med 1998;38:309–315.

34. Higashi A, Yashiro H, Kiyota K, et al. Validation of the Hospital Anxiety and Depression Scale in a gastro-intestinal clinic [in Japanese]. Nippon Shokakibyo Gakkai Zasshi 1996;93(12):884–892.

35. Hosaka T, Aoki T. Depression among cancer patients. Psychiatry Clin Neurosci 1996;50(6):309–312.

36. Kugaya A, Akechi T, Okuyama T, Okamura H, Uchitomi

Y. Screening for psychological distress in Japanese cancer patients. Jpn J Clin Oncol 1998;28(5):333–338.

37. Miyaoka H, Otsubo T, Yoshimura Y, Kamijima K, Miyaoka Y. Reliability and validity of the modified Japanese version of the short-form Eysenck Personality Questionnaire. Showa Univ J Med Sci 1999;11(1):33–36.

38. Melzack R. The McGill Pain Questionnaire. Major properties and scoring method. Pain 1970;1:277–299.

39. Satow A, Nakatani K, Taniguchi S. Evaluation of Japanese version of McGill Pain Questionnaire [in Japanese]. In: Japanese Psychological Association (ed). Proceedings of the 52nd Congress of Japanese Psychological Association. Tokyo: Japanese Psychological Association Printing Office, 1988:542.

40. Rugh JD, Woods BJ, Dahlstrom L. Temporomandibular disorders: Assessment of psychological factors. Adv Dent Res 1993;7:127–136.

41. Gurland BJ, Wilder DE, Berkman C. Depression and disability in the elderly: Reciprocal relations and changes with age. Int JGeriatr Psychiatr 1988;3:163–179.

42. Wright GE, Parker JC, Smarr KL, Johnson JC, Hewett JE, Walker SE. Age, depressive symptoms, and rheumatoid arthritis. Arthritis Rheum 1998;41:298–305.

43. Becker N, Thomsen AB, Olsen AK, Sjogren P, Bech P, Eriksen J. Pain epidemiology and health-related quality of life in chronic nonmalignant pain patients referred to a Danish multidisciplinary pain center. Pain 1997; 73(3):393–400.

44. Von Korff M, Dworkin SF, Le Resche L, Kruger A. An epidemiologic comparison of pain complaints. Pain 1988;32(2):173–183.

45. Benjamin S, Barnes D, Berger S, Clarke I, Jeacock J. The relationship of chronic pain, mental illness and organic disorders. Pain 1988;32(2):185–195.

46. McCreary C, Turner J, Dawson E. Principal dimensions of the pain experience and psychological disturbance in chronic low back pain patients. Pain 1981;11:85–92.

47. Kremer E, Atkinson JH Jr. Pain measurement: Construct validity of the affective dimension of the McGill Pain Questionnairewith chronic benign pain patients. Pain 1981;11:93–100.

48. Atkinson JH Jr, Kremer E, Ignelzi RJ. Diffusion of pain language with affective disturbance confounds differential diagnosis.Pain 1982;12:375–384.

49. Kremer EF, Atkinson JH, Kremer AM. The language of pain: Affective descriptors of pain are a better predictor of psychological disturbance than pattern of sensory and affective descriptors. Pain 1983;16:185–192.

50. Sist TC, Florio GA, Miner MF, Lema MJ, Zevon MA. The relationship between depression and pain language in cancer and chronic non-cancer pain patients. J Pain Symptom Manage 1998;15:350–358.

51. Mendelson G. Compensation, pain complaints, and psychological disturbance. Pain 1984;20:169–177.

52. Duggan C, Sham P, Lee A, Minne C, Murray R. Neuroticism: A vulnerability marker for depression evidence from a family study. J Affect Disord 1995; 35:139–143.

53. Roberts SB, Kendler K. Neuroticism and self-esteem as indexes of the vulnerability to major depression in women. Psychol Med 1999;29(5):1101–1109.

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