The association between psychological factors and oro-facial pain: a community-based study

Tatiana V Macfarlane, John Kincey, Helen V Worthington
European Journal of Pain: EJP 2002, 6 (6): 427-34

OBJECTIVE: To examine the hypothesis that psychological factors of psychological distress, maladaptive response to illness and perception of happiness in childhood, are associated with self-reported oro-facial pain (OFP).

METHOD: A cross-sectional population-based study was conducted in South-East Cheshire, UK. The adjusted participation rate was 74%, and 2504 adults aged 18-65 years participated in the study.

RESULTS: A report of not having had a happy childhood was associated with risk of 1.6 (95% CI 1.4-2.0) of reporting OFP. An increased propensity to report symptoms associated with OFP was seen for those individuals with higher levels of psychological distress measured using the general health questionnaire (GHQ) with the risk of 2.7 (95% CI 2.3-3.2) in the highest category. All components of the illness behaviour questionnaire (IBQ) were associated with presence of OFP. There was a linear increase in risk (test for trend, P<0.01) associated with the report of OFP for general hypochondriasis, disease conviction, affective inhibition, affective disturbance, and irritability. However there was a significant decrease in risk with a high score for perception of illness (0.6; 95% CI 0.6-0.7) and denial (0.6; 95% CI 0.5-0.7). None of the factors showed significant change in estimates when adjusted for age and gender.

CONCLUSIONS: This large cross-sectional community-based study showed significant association for all of the factors considered. The obtained data raise interesting questions of cause and effect for which further, longitudinal studies are required to establish temporal relationship between these factors and the onset, cause, and treatment of OFP.

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