1 / 2

顳顎關節障礙患者的精神輪廓

顳顎關節障礙患者的精神輪廓.

madeline-willis
Download Presentation

顳顎關節障礙患者的精神輪廓

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 顳顎關節障礙患者的精神輪廓 • 顳顎障礙的形成是多因性的，即是包含許多形成因素。 許多研究顯示TMD患者比對照組健康人有較多焦慮傾向。因此Engel在1977年首度對TMD / orofacial pain提出Biopsychosocial model。本研究利用精神症狀量表BSRS探討TMD患者１０種精神症狀分類、分佈情形，並與正常值比較。 研究假說(hypothesis)為：某類顳顎障礙患者有特殊精神症狀 ? 研究動機:比較顳顎障礙患者在精神輪廓是否與正常人有所不同？ 本研究目的即在使用精神症狀量表，探討不同類型TMD患者的精神症狀，瞭解那些症狀特別明顯，並據以簡化精神問卷。 研究目標: 1. 探討四類顳顎障礙患者10種精神症狀差異程度。 2. 與一般牙科患者比較，差異程度如何？ 本研究選取台北醫學大學附設醫院顳顎障礙 • 特別門診就診之新病患。診察內容包括病人基本資料、全身健康情況、主訴、發病至就診時的間距。填寫顱顎機能障礙問卷及簡式症狀表(BSRS)。使用臨床檢查表,記錄檢查結果。 統計整理２７０份樣本資料，即為本研究實驗組材料。 選取台北市內湖區某基層牙醫診所，選取全口牙結石清除（洗牙）及牙體復形（補牙）的就診病患（就醫時皆無疼痛的因素），經臨床檢查無關節及肌肉症狀，非TMD病患作為本研究的對照組。 研究結果為頭-臉-頸肌肉疼痛患者，10種精神向度明顯與其他顳顎障礙患者及對照組不同，並且各項向度數值均大於其他顳顎障礙患者及對照組。 以 T-SCORE 計算其差異程度，大於一倍標準差者為：身體化症狀、強迫性症狀、憂鬱、焦慮、敵意、附加症狀六種精神分項症狀。與精神科、家醫科、外科患者比較，頭-臉-頸肌肉疼痛患者及精神科患者明顯與其他六科不同，並且各項數值均大。本研究顯示若將頭-臉-頸肌肉疼痛獨立為一特別診斷分類，則可發現頭-臉-頸肌肉疼痛的精神分項迥異於其他顳顎障礙患者及對照組。因而証實研究假說：某類 TMD患者有特殊精神症狀。

  2. Psychological profile of temporomandibular disorder patients • The purpose of this study is to identify the psychological profile of temporomandibular disorder (TMD) patients. The authors applied one of the self-report models of psychological measurement, Brief Symptom Rating scale (BSRS). The experiment group was 270 temporomandibular disorder patients who visited TMJ center, Taipei Medical University Hospital. Patients were divided into four subgroups (Disc derangement with reduction, TMJ arthralgia and arthritis, head-face-neck myalgia, and local myalgia) according to chief complain and clinical examination. The control group was non-TMD patients who visited local dental clinic for cavity restoration or scaling. There is no pain complained during visits. Significant psychological profiles difference was uncovered when head-face-neck myalgia subpopulation was compared with the other three groups and control group. Significant difference exists in Somatization, Obsession, Depression, Anxiety, Hostility and Addition in terms of T-score. It is also noteworthy, from a treatment-planning perspective, which up to 27 % of TMD patients may have severe emotional distress to the point of appearing psychopathological on screening measures. The combination of supportive psychotherapy may be necessary for the optimal treatment outcome and it also illustrate the importance of consultation-liaison psychiatry in the dental field.

More Related