Post-traumatic Stress Disorder Among Patients with Orofacial Pain

Aims: To examine the presence and impact of post-traumatic stress disorder (PTSD) in a sample of patients seeking treatment for orofacial pain. Methods: One hundred forty-one consecutive patients with an array of orofacial pain conditions were screened using a structured clinical interview for PTSD and the PTSD Symptom Checklist—Civilian Version (PCL), a brief PTSD self-report inventory. Additionally, participants received a clinical examination and self-report questionnaires to assess pain, coping styles, and presence of post-traumatic symptoms. Results: Thirty-three (23%) patients received a full lifetime or current PTSD diag-nosis, with an additional 11 patients receiving a partial PTSD diagnosis. Only 5 of these 44 patients had ever been previously diagnosed with PTSD. PTSD symptoms were associated with higher pain scores (P < .05) and affective distress (P < .01). Furthermore, discriminant function analyses suggested that the PCL accurately classified 89% of these cases (sensitivity = .85, specificity = .90, postive predictive power = 74%, negative predic-tive power = 95%). Conclusion: These results suggest that PTSD is prevalent in the orofacial pain setting and that PTSD symp-tomatology is associated with increased pain and affective distress that may complicate clinical presentation. Furthermore, PTSD can be accurately and efficiently assessed using a brief, self-report inventory.

orofacial pain; post-traumatic stress disorder; temporomandibular disorders

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