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Widespread pain symptoms and psychological distress in southern Chinese with orofacial pain
Authors:A S MCMILLAN  M C M WONG  J ZHENG  Y LUO  & C L K LAM
Affiliation:Oral Rehabilitation, Faculty of Dentistry;, Dental Public Health, Faculty of Dentistry;and Family Medicine Unit, Faculty of Medicine, University of Hong Kong, Hong Kong, China
Abstract:Summary  The study investigated the experience of widespread pain (WP) symptoms and psychological distress in southern Chinese with orofacial pain (OFP). A community-based, cross-sectional case–control study involving people aged 35–70 registered with the Hospital Authority/University of Hong Kong Family Medicine Clinic served as the sampling frame. People with recent OFP symptoms and a group without OFP took part. Standard questions were asked about OFP conditions in the previous month. Psychological status was evaluated through depression, and non-specific physical symptoms (NPS) scores were measured with depression and somatization sub-scales of the Symptom Checklist-90. Widespread pain was determined using body outline drawings to identify painful sites prior to a standard clinical examination. Two hundred people with OFP and 200 without OFP participated. Compared with 5·0% in the comparison group ( P  =   0·005), 13·5% of participants with OFP had WP (OFP/WP). Multiple OFP symptoms were more common in the OFP/WP sub-group than the OFP sub-group without WP (OFP/No WP) ( P  <   0·002). Sixty-three percent of the OFP/WP sub-group had moderate/severe depression scores compared with 26·0% in the OFP/No WP sub-group ( P  <   0·001). When pain items were included and excluded, 92·6% and 88·9% of the OFP/WP sub-group had moderate/severe NPS scores, respectively compared with 68·5% and 65·0% in the OFP/No WP sub-group ( P  =   0·004). Co-morbid WP occurred relatively often in southern Chinese with OFP. Psychological distress was common in OFP sufferers, particularly those with WP. A multidisciplinary approach to treatment including cognitive/behavioural therapy should be considered in Chinese people with OFP as part of a WP pattern.
Keywords:orofacial pain  clinical assessment  widespread pain  psychological  depression  somatization  Chinese
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