Depression, anhedonia and anxiety in temporomandibular joint and other facial pain syndromes

Abstract

Depression, anhedonia, state anxiety (A-state), trait anxiety (A-trait) and self-reported pain estimate were measured in almost 500 facial pain patients. These patients were divided into 3 diagnostic categories: myofascial pain dysfunction syndrome (MPD), arthritis of the temporomandibular joints (TMJ arthritis) and trigeminal neuralgia. Three control groups were measured for comparison. They consisted of a normal or non-patient group, a group of arthritis patients and a group of movement disorder patients attending a neurology clinic. Among the facial pain patients and the normal controls few differences were found with regard to anhedonia and depression. The arthritis and neurology patients produced significantly higher depression and anhedonia scores than did several of the facial pain groups. Pain estimate ranged from 0 for the controls to a mean of 67.6 .+-. 31.3 for the trigeminal neuralgia patients, with the MPD (.hivin.x = 56.2 .+-. 32.5) and the TMJ arthritis patients (.hivin.x = 46.7 .+-. 30.8) somewhat lower. Clinical variables such as duration of pain, help-seeking behavior and total number of symptoms were correlated with depression, but not with anhedonia scores. It is hypothesized that anhedonia is a measure separate from depression and may be more closely linked to suffering behavior than to pain behavior. Psychological variables did not discriminate among facial pain patients and, in particular, did not distinguish between so-called functional and organic illness.