AIMS: To test the usefulness of tailoring cognitive-behavioral therapy (CBT) for patients with temporomandibular disorders (TMD) who demonstrated poor psychosocial adaptation to their TMD condition, independent of physical diagnosis. METHODS: A randomized clinical trial compared a 6-session CBT intervention delivered in conjunction with the usual TMD treatment to the usual conservative treatment by TMD specialist dentists. For study inclusion, Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), Axis II criteria, were used to target patients with elevated levels of TMD pain-related interference with daily activities, independent of physical diagnosis (i.e., Axis I). RESULTS: At the post-treatment assessment, about 4 months after the baseline evaluations, the comprehensive care group, when compared to the usual treatment group, showed significantly lower levels of characteristic pain intensity, significantly higher self-reported ability to control their TMD pain, and a strong trend (P = .07) toward lower pain-related interference in daily activities. From post-intervention to 1-year follow-up, all subjects showed improvement. At the 1-year follow-up, the comprehensive care group, while not losing any of its early gains, was not significantly different from the usual care group with regard to reported levels of pain, ability to control pain, and levels of interference in activities. For many of these psychosocially disabled TMD patients, pain and interference 1 year after treatment remained at the same or higher levels than those observed at baseline among a group of patients selected for a separate randomized clinical trial on the basis of better psychosocial adaptation. CONCLUSION: The 6-session CBT intervention for patients with heightened psychologic and psychosocial disability was effective in improving pain-related variables over the course of the CBT in conjunction with usual treatment, but was too brief an intervention to result in further improvement after the sessions ended. Patient ratings of treatment satisfaction and helfulness were high for both groups, but they were significantly higher for the comprehensive care group.
RCT Entities:
AIMS: To test the usefulness of tailoring cognitive-behavioral therapy (CBT) for patients with temporomandibular disorders (TMD) who demonstrated poor psychosocial adaptation to their TMD condition, independent of physical diagnosis. METHODS: A randomized clinical trial compared a 6-session CBT intervention delivered in conjunction with the usual TMD treatment to the usual conservative treatment by TMD specialist dentists. For study inclusion, Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), Axis II criteria, were used to target patients with elevated levels of TMD pain-related interference with daily activities, independent of physical diagnosis (i.e., Axis I). RESULTS: At the post-treatment assessment, about 4 months after the baseline evaluations, the comprehensive care group, when compared to the usual treatment group, showed significantly lower levels of characteristic pain intensity, significantly higher self-reported ability to control their TMD pain, and a strong trend (P = .07) toward lower pain-related interference in daily activities. From post-intervention to 1-year follow-up, all subjects showed improvement. At the 1-year follow-up, the comprehensive care group, while not losing any of its early gains, was not significantly different from the usual care group with regard to reported levels of pain, ability to control pain, and levels of interference in activities. For many of these psychosocially disabled TMDpatients, pain and interference 1 year after treatment remained at the same or higher levels than those observed at baseline among a group of patients selected for a separate randomized clinical trial on the basis of better psychosocial adaptation. CONCLUSION: The 6-session CBT intervention for patients with heightened psychologic and psychosocial disability was effective in improving pain-related variables over the course of the CBT in conjunction with usual treatment, but was too brief an intervention to result in further improvement after the sessions ended. Patient ratings of treatment satisfaction and helfulness were high for both groups, but they were significantly higher for the comprehensive care group.
Authors: Eric Schiffman; Richard Ohrbach; Edmond Truelove; John Look; Gary Anderson; Jean-Paul Goulet; Thomas List; Peter Svensson; Yoly Gonzalez; Frank Lobbezoo; Ambra Michelotti; Sharon L Brooks; Werner Ceusters; Mark Drangsholt; Dominik Ettlin; Charly Gaul; Louis J Goldberg; Jennifer A Haythornthwaite; Lars Hollender; Rigmor Jensen; Mike T John; Antoon De Laat; Reny de Leeuw; William Maixner; Marylee van der Meulen; Greg M Murray; Donald R Nixdorf; Sandro Palla; Arne Petersson; Paul Pionchon; Barry Smith; Corine M Visscher; Joanna Zakrzewska; Samuel F Dworkin Journal: J Oral Facial Pain Headache Date: 2014
Authors: Gianluca Castelnuovo; Emanuele M Giusti; Gian Mauro Manzoni; Donatella Saviola; Arianna Gatti; Samantha Gabrielli; Marco Lacerenza; Giada Pietrabissa; Roberto Cattivelli; Chiara A M Spatola; Stefania Corti; Margherita Novelli; Valentina Villa; Andrea Cottini; Carlo Lai; Francesco Pagnini; Lorys Castelli; Mario Tavola; Riccardo Torta; Marco Arreghini; Loredana Zanini; Amelia Brunani; Paolo Capodaglio; Guido E D'Aniello; Federica Scarpina; Andrea Brioschi; Lorenzo Priano; Alessandro Mauro; Giuseppe Riva; Claudia Repetto; Camillo Regalia; Enrico Molinari; Paolo Notaro; Stefano Paolucci; Giorgio Sandrini; Susan G Simpson; Brenda Wiederhold; Stefano Tamburin Journal: Front Psychol Date: 2016-02-19
Authors: Cheryl Ritenbaugh; Richard Hammerschlag; Samuel F Dworkin; Mikel G Aickin; Scott D Mist; Charles R Elder; Richard E Harris Journal: J Pain Date: 2012-10-09 Impact factor: 5.820
Authors: Gary C Anderson; Yoly M Gonzalez; Richard Ohrbach; Edmond L Truelove; Earl Sommers; John O Look; Eric L Schiffman Journal: J Orofac Pain Date: 2010
Authors: Beverly E Thorn; Melissa A Day; John Burns; Melissa C Kuhajda; Susan W Gaskins; Kelly Sweeney; Regina McConley; L Charles Ward; Chalanda Cabbil Journal: Pain Date: 2011-09-14 Impact factor: 6.961
Authors: Cheryl Ritenbaugh; Richard Hammerschlag; Carlo Calabrese; Scott Mist; Mikel Aickin; Elizabeth Sutherland; Joseph Leben; Lynn Debar; Charles Elder; Samuel F Dworkin Journal: J Altern Complement Med Date: 2008-06 Impact factor: 2.579