Browsing by Subject "RESEARCH DIAGNOSTIC-CRITERIA"

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  • Kotiranta, Ulla; Forssell, Heli; Kauppila, Timo (2019)
    Objective: We studied whether primary care temporomandibular disorder (TMD) patients reporting different levels of pain-related disability differ in terms of comorbid pains, general health conditions and quality of life. Material and methods: Consecutive TMD pain patients (n = 399) seeking treatment in primary care completed a questionnaire on comorbid pains and their interference and the Finnish version of the RAND-36-item quality of life questionnaire. Medical diagnoses confirmed by doctors were recorded. The patients were classified according to the Graded Chronic Pain Scale (GCPS) of the Research Diagnostic Criteria for TMD (RDC/TMD). The patients were classified: no disability group (0 disability points), low disability group (1-2 disability points) and high disability group (3-6 disability points). Results: Compared to patients in the no-disability group, patients in the high- and low-disability groups reported more comorbid pain conditions (p <.001), and experienced these as more intense and interfering more with daily life (p <.05). Patients in the high-disability group reported more general health-related medical diagnoses than patients in the no-disability group (p <.05). Furthermore, patients with low or high pain-related disability indicated poorer quality of life in all RAND-36 subscales than those with no disability (p <.05). Conclusions: The findings suggest that GCPS-related disability scoring can be used as a simple screening instrument to identify TMD patients with different degrees of health burdens.
  • Forssell, Heli; Teerijoki-Oksa, Tuija; Puukka, Pauli; Estlander, Ann-Mari (2020)
    Abstract Background Burning mouth syndrome (BMS) patients are psychologically distressed, but whether this associates with symptom severity is unclear. Objective To investigate the association of psychological factors with pain intensity and interference in BMS. Methods 52 women (mean age 63.1, SD 10.9) with BMS participated. Pain intensity and interference data was collected using 2-week pain diaries. Psychological factors were evaluated using Depression scale (DEPS), Pain anxiety symptom scale (PASS) and Pain vigilance and awareness questionnaire (PVAQ). The local ethical committee approved the study. Patients were divided into groups based on pain severity distribution tertiles: low intensity (NRS ≤ 3.7) or interference (NRS ≤2.9) (tertiles 1-2, n=35) and moderate to intense intensity (NRS > 3.7) or interference (>2.9)(tertile 3, n= 17). T-test, Wilcoxon Test and Pearson's Correlation Coefficient were used in the analyses. Results Patients in the highest intensity and interference tertiles reported more depression (P = .0247 and P = .0169) and pain anxiety symptoms (P = .0359 and P = .0293), and were more preoccupied with pain (P = .0004 and P = .0003) than patients in the low intensity and interference groups. The score of the pain vigilance questionnaire correlated significantly with pain intensity (r= .366, P= .009 and interference (r= .482, P = .009). Depression (r=. 399, P = .003) and pain anxiety symptoms (r= .452, P = .001) correlated with pain interference. Conclusion Symptom severity in BMS associates with symptoms of psychological distress emphasizing the need to develop multidimensional diagnostics for the assessment of BMS pain.
  • Forssell, Heli; Sipilä, Kirsi; Teerijoki-Oksa, Tuija; Vartiainen, Pekka; Kautiainen, Hannu; Sintonen, Harri; Kalso, Eija (2020)
    Background and aims: Health-related quality of life (HRQoL) assessments have been widely used in pain medicine as they are able to reflect the subjective and multidimensional nature of chronic pain. Studies have shown a consistent impairment in HRQoL in different chronic pain conditions. However, it is not known whether HRQoL is impaired in chronic orofacial pain (OFP). The generic 15D HRQoL instrument has been shown to fare as well as or better than other generic HRQoL instruments in the study of chronic pain. The aim was to investigate HRQoL in patients with chronic OFP using the generic 15D HRQoL instrument. The validity of the instrument was tested by studying the association of the 15D data with pain interference. Methods: One hundred fifty-one patients (mean age 50 years, SD 15 years, 119 females) were recruited from three tertiary facial pain clinics. HRQoL data of the participants were contrasted with that of an age- and gender-standardized sample of general population by comparing the mean 15D scores and profiles. The data for the general population came from the National Health 2011 Survey representing Finnish population aged 18 years and older. Pain interference was assessed using Brief Pain Inventory. Based on pain interference distribution the participants were divided into tertiles. Statistical comparison between patient and population HRQoL values were performed using Monte-Carlo-type simulations. Statistical significance for the hypothesis of linearity was evaluated by using generalized linear models. Results: The mean 15D score of OFP patients (0.824, SD 0.113) was statistically significantly lower than that of the age- and gender-standardized general population (0.929, SD 0.019) (p <0.001). The difference between the patients and the general population was also clinically important, i.e. over the minimum clinically important difference in the 15D score. All mean 15D dimension values were significantly lower compared with the general population values (p <0.001 for all dimensions). The largest differences were seen in the dimensions of discomfort and symptoms (0.418, SD 0.222 vs. 0.816, SD 0.027), sleeping (0.693, SD 0.258 vs. 0.838, SD 0.029), and vitality (0.702, SD 0.221 vs. 0.884 SD 0.026). There was a statistically significant linear decrease in the 15D dimension values (p <0.001) with increasing pain interference. The greatest differences were found on the dimensions of discomfort and symptoms, sleeping and vitality. Conclusions: HRQoL is significantly impaired in patients with chronic OFP. A decrease in the 15D dimension values with increasing pain interference indicated convergent validity between 15D and pain interference. Implications: The findings suggest that 15D is an appropriate instrument for use in the assessment of HRQoL in OFP patients. By showing the usefulness of the 15D, the present study may encourage further use of generic HRQoL assessments in the study of chronic OFP, and contribute e.g. to the implementation of HRQoL as one of the core outcome measures in future treatment studies on chronic OFP.