Psychosocial behaviour and health care utilization in patients suffering from temporomandibular disorders diagnosed on the basis of clinical findings and MRI examination

Eur J Pain. 2005 Jun;9(3):243-50. doi: 10.1016/j.ejpain.2004.07.001.


The aim of this study was to evaluate psychosocial behaviour and differences in health care utilization between subgroups of patients suffering from temporomandibular disorders, using both clinical examination and magnetic resonance imaging (MRI).

Materials and methods: 70 patients were examined according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD), and were divided into groups according to their clinical diagnoses. MRIs were acquired and joint-related RDC/TMD diagnoses were modified on the basis of MRI findings. Group I suffered from joint pathology, group II from myofascial pain and group III from a combination. Non-parametric statistics were used to reveal group-related differences in psychosocial and behavioural aspects. Differences in group assignment based on clinical and MRI examination were assessed (kappa statistics).

Results: MRI findings led to group assignments that were different from clinical assignments (k = 0.3). For both types of assignment, patients with myofascial pain displayed higher somatization scores, used more splints and consulted more physicians. For clinical assignment only, depression scores were higher in the myofascial pain group. For MRI based assignment, sex differences were significant between groups I and III.

Conclusion: Somatization-specific behaviour is more widespread in patients suffering from exclusively myofascial pain than in patients presenting joint pathology. Inconsistencies in differences of other psychosocial variables between groups of TMD patients seem to be related to differences in group assignment either with or without objective information on joint pathology.

MeSH terms

  • Adult
  • Delivery of Health Care / statistics & numerical data*
  • Disability Evaluation
  • Female
  • Health Behavior*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pain Measurement
  • Psychological Tests
  • Somatoform Disorders / diagnosis
  • Temporomandibular Joint Disorders / diagnosis*
  • Temporomandibular Joint Disorders / psychology*