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Evaluation of Anxiety and Depression in Patients with Disc Displacement according to Diagnostic Criteria for Temporomandibular Disorders
J Oral Med Pain 2018;43:125-130
Published online December 30, 2018;
© 2018 Korean Academy of Orofacial Pain and Oral Medicine

Junhyong Park1, Young-Joo Shim1,3, Hyun-Dae Lim2,3, You-Mee Lee2,3, Jin-Kyu Kang1,3

1Department of Orofacial Pain and Oral Medicine, Wonkwang University Daejeon Dental Hospital, Daejeon, Korea 2Department of Oral Medicine, College of Dentistry, Wonkwang University, Iksan, Korea 3Wonkwang Dental Research Institute, Wonkwang University, Iksan, Korea
Correspondence to: Jin-Kyu Kang Department of Orofacial Pain and Oral Medicine, Wonkwang University Daejeon Dental Hospital, 77 Dunsanro, Seo-gu, Daejeon 35233, Korea
Tel: +82-42-366-1125
Fax: +82-42-366-1115
Received November 16, 2018; Revised November 29, 2018; Accepted November 29, 2018.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: The etiology of temporomandibular disorders (TMDs) is complex and multifactorial including trauma, anatomical, pathophysiological, social and psychological factors. Psychological factors can induce or sustain TMDs in various ways. And psychological problems, such as anxiety and depression can be occurred due to TMDs. Therefore, evaluation of psychological factors in patients with TMDs is important. Although disc displacement (DD) is crucial in clinical situation, most of studies have focused on the relationship of psychosocial factors and myofascial pain. And also, Subtypes of DD can cause different degrees of discomfort, it is necessary to evaluate the psychological states of the patients according to the subtype. The Hospital Anxiety Depression Scale (HADS) is one of the self-report questionnaire to evaluate the psychological factors. HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) are assessed through 14 questions. The purpose of this study was to evaluate anxiety and depression assessed by HADS in patients diagnosed with subtypes of DD according to diagnostic criteria for TMDs.
Methods: Four hundred thirty nine patients were diagnosed as one of the subtypes of DD. One hundred fourty nine subjects with no symptoms were set as control groups. All of them answered the HADS for Koreans. The cut-off score for anxiety and depression was set a score of 8. The chi-square test was performed to evaluate association between DD and anxiety/depression.
Results: There was a significant difference in HADS-D between five groups (p<0.01). However, there was no significant difference in HADS-A. All the DD groups showed a significant difference in HADS-D compared with the control group except the DD without reduction without limited opening group. The DD without reduction with limited opening group showed the highest rates in HADS-D (40.4%).
Conclusions: Based on the above results, it is necessary to consider the depression in treatment of the patients with DDs.
Keywords : Anxiety; Depression; Diagnostic criteria for temporomandibular disorder; Disc displacement; Temporomandibular disorders

December 2018, 43 (4)