颞颌关节紊乱病患者心理学相关因素分析

A Clinical Study of Interrelated Psychological Factors in Patients with Temporomandibular Joint Disturbances

目的对40例非咬合因素引起的颞颌关节紊乱病(TMD)患者进行心理学研究,了解TMD与心理障碍的关系。方法对40例TMD患者进行心理学病因、心因性躯体化症状观察,并对与TMD患者相配对的正常组进行自评焦虑量表(SAS)、自评抑郁量表(SDS)、症状自评量表(SCL90)量表分析。结果40例TMD患者主要的心理学病因有恐癌症、疑病症,工作紧张,生活事件,家庭矛盾。所有患者均存在心因性躯体化症状,最常见为睡眠障碍;存在中、重度的焦虑(75％)和抑郁(90％);SCL90量表主要是焦虑、抑郁、敌对和躯体化(P<0.01)。结论 非咬合因素引起的TMD患者存在着不同程度的心理障碍,心理学病史、躯体化症状具有临床参考价值;心理量表分析可进一步明确心理障碍的类型和程度,心理行为治疗对这类TMD有一定的帮助。

Objective To understand the relations between Temporomandibular Joint Disturbances (TMD) and psychological problems. Methods 40 cases with TMD were studied about their psychological factors and psychological body symptoms. All the cases either with TMD or without TMD were analyzed with SAS, SDS, SCL90 scales. Results The main psychological factors in the 40 cases with TMD were cancer-fear, disease-suspicion, work-tension and family contradiction. Psychological body symptoms among these patients were sleeping problems, moderate-severe depression (75%) and anxiety (90%) . SCL90 scale gave mainly priority to Anxiety, Depression, Rivalry, and Somatization ( P < 0.01) . Conclusion Psychological body symptoms were of value in clinical diagnosis, and psychological scales could define the types and degrees of psychological problems. Further and psychological behavior treatments would be of some help to these cases.