The impact of the lockdown by COVID-19 on Temporomandibular Disorder related pain intensity, distress and post-traumatic stress disorder - A case-control study

Authors

DOI:

https://doi.org/10.33448/rsd-v11i2.25919

Keywords:

COVID-19; Social isolation; Mental health; Post-traumatic stress disorder; Temporomandibular joint disorders.

Abstract

The events related to the COVID-19 pandemic are having a strong impact on public mental health. However, there are few studies focusing on these aspects in patients with temporomandibular disorders (TMD). The aim of this study was to evaluate the painful intensity, distress and symptoms of post-traumatic stress disorder (PTSD) in a population with and without TMD during the COVID-19 pandemic. This case-control study evaluated electronic questionnaires from 197 participants (105 with TMD and 92 controls), that were carried out during and after the first lockdown due to COVID-19 pandemic. To assess the presence of possible TMD, painful intensity, distress, and PTSD symptoms the respective questionnaires were used: TMD Pain Screener, Numeric Rating Scale, Patient Health Questionnaire – 4 and PTSD Checklist - Civilian Version. TMD participants showed higher levels of distress during (p = 0.027) and after (p < 0.001) the lockdown compared to the control group. The TMD group also reported increased levels of distress in the post-lockdown period in relation to the period during the lockdown (p = 0.002), although the same intensity of pain was observed at both evaluated periods. Furthermore, participants with TMD were 3.91 × more likely to be female (CI 95% = 1.88-8.13) and 3.82 × more likely to show PTSD symptoms (CI95% = 1.61-9.08) after the lockdown. These data suggest that a pre-existing painful condition can lead to increased distress and symptoms of PTSD as a result of stressful situations, such as the COVID-19 pandemic lockdown.

References

Afari, N., Ahumada, S. M., Wright, L. J., Mostoufi, S., Golnari, G., Reis, V., & Cuneo, J. G. (2014). Psychological trauma and functional somatic syndromes: A systematic review and meta-analysis. Psychosomatic Medicine, 76(1), 2–11. https://doi.org/10.1097/PSY.0000000000000010.

Ahmad, A., Rehman, M. U., & Alkharfy, K. M. (2020). An alternative approach to minimize the risk of coronavirus (Covid-19) and similar infections. European Review for Medical and Pharmacological Sciences, 24(7), 4030–4034. https://doi.org/10.26355/EURREV_202004_20873.

Almeida-Leite, C. M., Stuginski-Barbosa, J., & Conti, P. C. R. (2020). How psychosocial and economic impacts of COVID-19 pandemic can interfere on bruxism and temporomandibular disorders? Journal of Applied Oral Science, 28. https://doi.org/10.1590/1678-7757-2020-0263.

Asquini, G., Bianchi, A. E., Borromeo, G., Locatelli, M., & Falla, D. (2021). The impact of Covid-19-related distress on general health, oral behaviour, psychosocial features, disability and pain intensity in a cohort of Italian patients with temporomandibular disorders. Plos One, 16(2), e0245999. https://doi.org/10.1371/journal.pone.0245999.

Bringhenti, M. E., Luft, C. D. B., & Oliveira, W. F. de. (2010). Transtorno do estresse pós-traumático em acidentes de trânsito: validação de escala. Psico-USF, 15(2), 193–203. https://doi.org/10.1590/s1413-82712010000200007.

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet, 395(10227), 912–920. https://doi.org/10.1016/S0140-6736(20)30460-8.

Campos, J. A. D. B., Martins, B. G., Campos, L. A., Marôco, J., Saadiq, R. A., & Ruano, R. (2020). Early Psychological Impact of the COVID-19 Pandemic in Brazil: A National Survey. Journal of Clinical Medicine, 9(9), 2976. https://doi.org/10.3390/jcm9092976.

Cénat, J. M., Blais-Rochette, C., Kokou-Kpolou, C. K., Noorishad, P.-G., Mukunzi, J. N., McIntee, S.-E., Dalexis, R. D., Goulet, M.-A., & Labelle, P. (2020). Prevalence of Symptoms of Depression, Anxiety, Insomnia, Posttraumatic Stress Disorder, and Psychological Distress among Populations Affected by the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Psychiatry Research, 113599. https://doi.org/10.1016/j.psychres.2020.113599.

Daly, M., & Robinson, E. (2020). Psychological distress and adaptation to the COVID-19 crisis in the United States. Journal of Psychiatric Research, August, 1–7. https://doi.org/10.1016/j.jpsychires.2020.10.035.

De La Torre Canales, G., Câmara-Souza, M. B., Muñoz Lora, V. R. M., Guarda-Nardini, L., Conti, P. C. R., Rodrigues Garcia, R. M., Del Bel Cury, A. A., & Manfredini, D. (2018). Prevalence of psychosocial impairment in temporomandibular disorder patients: A systematic review. Journal of Oral Rehabilitation, 45(11), 881–889. https://doi.org/10.1111/joor.12685.

Dworkin, R. H., Turk, D. C., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Katz, N. P., Kerns, R. D., Stucki, G., Allen, R. R., Bellamy, N., Carr, D. B., Chandler, J., Cowan, P., Dionne, R., Galer, B. S., Hertz, S., Jadad, A. R., Kramer, L. D., Manning, D. C., … Witter, J. (2005). Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain, 113(1–2), 9–19. https://doi.org/10.1016/j.pain.2004.09.012.

Emodi-Perlman, A., Eli, I., Smardz, J., Uziel, N., Wieckiewicz, G., Gilon, E., Grychowska, N., & Wieckiewicz, M. (2020). Temporomandibular Disorders and Bruxism Outbreak as a Possible Factor of Orofacial Pain Worsening during the COVID-19 Pandemic—Concomitant Research in Two Countries. Journal of Clinical Medicine, 9(10), 3250. https://doi.org/10.3390/jcm9103250.

Gaş, S., Ekşi Özsoy, H., & Cesur Aydın, K. (2021). The association between sleep quality, depression, anxiety and stress levels, and temporomandibular joint disorders among Turkish dental students during the COVID-19 pandemic. Cranio : The Journal of Craniomandibular Practice, 00(00), 1–6. https://doi.org/10.1080/08869634.2021.1883364.

Ge, H., Wang, X., Yuan, X., Xiao, G., Wang, C., Deng, T., Yuan, Q., & Xiao, X. (2020). The epidemiology and clinical information about COVID-19. European Journal of Clinical Microbiology and Infectious Diseases, 39(6), 1011–1019. https://doi.org/10.1007/s10096-020-03874-z.

Hossain, M. M., Sultana, A., & Purohit, N. (2020). Mental health outcomes of quarantine and isolation for infection prevention: A systematic umbrella review of the global evidence. Epidemiology and Health, e2020038. https://doi.org/10.4178/epih.e2020038.

Lei, L., Huang, X., Zhang, S., Yang, J., Yang, L., & Xu, M. (2020). Comparison of Prevalence and Associated Factors of Anxiety and Depression among People Affected by versus People Unaffected by Quarantine during the COVID-19 Epidemic in Southwestern China. Medical Science Monitor, 26, 1–12. https://doi.org/10.12659/MSM.924609.

Mackolil, J., & Mackolil, J. (2020). Addressing psychosocial problems associated with the COVID-19 lockdown. In Asian Journal of Psychiatry (Vol. 51, p. 102156). Elsevier B.V. https://doi.org/10.1016/j.ajp.2020.102156.

Maixner, W., Diatchenko, L., Dubner, R., Fillingim, R. B., Greenspan, J. D., Knott, C., Ohrbach, R., Weir, B., & Slade, G. D. (2011). Orofacial pain prospective evaluation and risk assessment study - The OPPERA study. Journal of Pain, 12(11 SUPPL.), T4-T11.e2. https://doi.org/10.1016/j.jpain.2011.08.002.

Malta, M., Cardoso, L. O., Bastos, F. I., Magnanini, M. M. F., & da Silva, C. M. F. P. (2010). STROBE initiative: guidelines on reporting observational studies. Revista de Saude Publica, 44(3), 559–565. https://doi.org/10.1590/s0034-89102010000300021.

McIntyre, P., Joo, Y. J., Chiu, C., Flanagan, K., & Macartney, K. (2021). COVID-19 vaccines - Are we there yet? Australian Prescriber, 44(1), 19–25. https://doi.org/10.18773/austprescr.2020.084.

Medeiros, R. A. De, Vieira, D. L., Silva, E. V. F. Da, Rezende, L. V. M. D. L., Santos, R. W. Dos, & Tabata, L. F. (2020). Prevalence of symptoms of temporomandibular disorders, oral behaviors, anxiety, and depression in Dentistry students during the period of social isolation due to COVID-19. Journal of Applied Oral Science, 28, 1–8. https://doi.org/10.1590/1678-7757-2020-0445.

Mertens, G., Gerritsen, L., Duijndam, S., Salemink, E., & Engelhard, I. M. (2020). Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020. Journal of Anxiety Disorders, 74, 102258. https://doi.org/10.1016/j.janxdis.2020.102258.

Nazeri, M., Ghahrechahi, H. R., Pourzare, A., Abareghi, F., Samiee-Rad, S., Shabani, M., Arjmand, S., & Abazarpour, R. (2018). Role of anxiety and depression in association with migraine and myofascial pain temporomandibular disorder. Indian Journal of Dental Research, 29(5), 583–587. https://doi.org/10.4103/0970-9290.244932.

Nguyen, T., Vanichanon, P., Bhalang, K., & Vongthongsri, S. (2019). Pain Duration and Intensity Are Related to Coexisting Pain and Comorbidities Present in Temporomandibular Disorder Pain Patients. Journal of Oral & Facial Pain and Headache, 33(2), 205–212. https://doi.org/10.11607/ofph.2088.

Ohrbach, R. (2016). Diagnostic Criteria for Temporomandibular Disorders: Assessment Instruments (Brazilian Portuguese). International Network for Orofacial Pain and Related Disorders Methodology, 1–74.

Ohrbach, R., & Knibbe, W. (2016). Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Scoring Manual for Self-Report Instruments. 18.

Ostrom, C., Bair, E., Maixner, W., Dubner, R., Fillingim, R. B., Ohrbach, R., Slade, G. D., & Greenspan, J. D. (2017). Demographic Predictors of Pain Sensitivity: Results From the OPPERA Study. Journal of Pain, 18(3), 295–307. https://doi.org/10.1016/j.jpain.2016.10.018.

Passos, L., Prazeres, F., Teixeira, A., & Martins, C. (2020). Impact on mental health due to covid-19 pandemic: Cross-sectional study in portugal and brazil. International Journal of Environmental Research and Public Health, 17(18), 1–13. https://doi.org/10.3390/ijerph17186794.

Pieh, C., Budimir, S., Delgadillo, J., Barkham, M., Fontaine, J. R. J., & Probst, T. (2020). Mental health during COVID-19 lockdown in the United Kingdom. Psychosomatic Medicine, Publish Ah. https://doi.org/10.1097/psy.0000000000000871.

Robinson, J. L., Johnson, P. M., Kister, K., Yin, M. T., Chen, J., & Wadhwa, S. (2020). Estrogen signaling impacts temporomandibular joint and periodontal disease pathology. Odontology, 108(2), 153–165. https://doi.org/10.1007/s10266-019-00439-1.

Saccomanno, S., Bernabei, M., Scoppa, F., Pirino, A., Mastrapasqua, R., & Visco, M. A. (2020). Coronavirus Lockdown as a Major Life Stressor: Does It Affect TMD Symptoms? International Journal of Environmental Research and Public Health, 17(23), 8907. https://doi.org/10.3390/ijerph17238907.

Salari, N., Hosseinian-Far, A., Jalali, R., Vaisi-Raygani, A., Rasoulpoor, S., Mohammadi, M., Rasoulpoor, S., & Khaledi-Paveh, B. (2020). Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: A systematic review and meta-analysis. Globalization and Health, 16(1), 1–11. https://doi.org/10.1186/s12992-020-00589-w.

Tjakkes, G. H. E., Reinders, J. J., Tenvergert, E. M., & Stegenga, B. (2010). TMD pain: The effect on health related quality of life and the influence of pain duration. Health and Quality of Life Outcomes, 8, 1–8. https://doi.org/10.1186/1477-7525-8-46.

Vindegaard, N., & Eriksen Benros, M. (2020). COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain, Behavior, and Immunity, May, 1–12. https://doi.org/10.1016/j.bbi.2020.05.048.

Vrbanović, E., Alajbeg, I. Z., & Alajbeg, I. (2020). COVID-19 pandemic and Zagreb earthquakes as stressors in patients with temporomandibular disorders. Oral Diseases, 0(June), 1–6. https://doi.org/10.1111/odi.13488.

Warren, M. P., & Fried, J. L. (2001). Temporomandibular disorders and hormones in women. Cells Tissues Organs, 169(3), 187–192. https://doi.org/10.1159/000047881.

Wu, Y., Xiong, X., Fang, X., Sun, W., Yi, Y., Liu, J., & Wang, J. (2021). Psychological status of TMD patients, orthodontic patients and the general population during the COVID-19 pandemic. Psychology, Health and Medicine, 26(1), 62–74. https://doi.org/10.1080/13548506.2020.1858489.

Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M. W., Gill, H., Phan, L., Chen-Li, D., Iacobucci, M., Ho, R., Majeed, A., & McIntyre, R. S. (2020a). Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of Affective Disorders, 277, 55–64. https://doi.org/10.1016/j.jad.2020.08.001.

Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M. W., Gill, H., Phan, L., Chen-Li, D., Iacobucci, M., Ho, R., Majeed, A., & McIntyre, R. S. (2020b). Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of Affective Disorders, 277(August), 55–64. https://doi.org/10.1016/j.jad.2020.08.001.

Zhang, J., Lu, H., Zeng, H., Zhang, S., Du, Q., Jiang, T., & Du, B. (2020). The differential psychological distress of populations affected by the COVID-19 pandemic. Brain, Behavior, and Immunity, 87(April), 49–50. https://doi.org/10.1016/j.bbi.2020.04.031

Downloads

Published

29/01/2022

How to Cite

LOPES, T. S.; SILVA, P. G. de B.; BEZERRA, M. M. .; FIAMENGUI, L. M. S. P. .; OLIVEIRA, E. M. de; PEREIRA , K. M. A. .; CHAVES, H. V. . The impact of the lockdown by COVID-19 on Temporomandibular Disorder related pain intensity, distress and post-traumatic stress disorder - A case-control study. Research, Society and Development, [S. l.], v. 11, n. 2, p. e41811225919, 2022. DOI: 10.33448/rsd-v11i2.25919. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/25919. Acesso em: 23 feb. 2024.

Issue

Section

Health Sciences