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van der Meer HA, Tol CHM, Speksnijder CM, van Selms MKA, Lobbezoo F, Visscher CM. Psychosocial factors associated with pain outcomes in patients with painful temporomandibular disorders and headaches. Eur J Oral Sci 2023; 131:e12919. [PMID: 36802069 DOI: 10.1111/eos.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/20/2023] [Indexed: 02/22/2023]
Abstract
The objective of this study was to assess the association between psychosocial factors (in terms of anxiety, somatization, depression, and optimism) and pain (in terms of headache pain intensity and pain-related disability), in patients with a painful temporomandibular disorder (TMD) and one of the following headache types: migraine, tension-type headache (TTH), or headache attributed to TMD, corrected for the influence of bruxism. A retrospective study was conducted at an orofacial pain and dysfunction (OPD) clinic. Inclusion criteria were painful TMD, with migraine, TTH, and/or headache attributed to TMD. Linear regressions were performed to assess the influence of psychosocial variables on pain intensity and on pain-related disability, stratified per headache type. The regression models were corrected for bruxism and the presence of multiple headache types. A total of 323 patients (61% female; mean age 42.9, SD 14.4 years) were included. Headache pain intensity only had significant associations in TMD-pain patients with headache attributed to TMD, and anxiety showed the strongest relation (β = 0.353) with pain intensity. Pain-related disability was most strongly associated with depression in TMD-pain patients with TTH (β = 0.444), and with somatization in patients with headache attributed to TMD (β = 0.399). In conclusion, the influence of psychosocial factors on headache pain intensity and pain-related disability depends on the headache type presenting.
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Affiliation(s)
- Hedwig A van der Meer
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Rehabilitation, Amsterdam Movement Sciences, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Cornel H M Tol
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Caroline M Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Maurits K A van Selms
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Corine M Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Caponnetto V, Deodato M, Robotti M, Koutsokera M, Pozzilli V, Galati C, Nocera G, De Matteis E, De Vanna G, Fellini E, Halili G, Martinelli D, Nalli G, Serratore S, Tramacere I, Martelletti P, Raggi A. Comorbidities of primary headache disorders: a literature review with meta-analysis. J Headache Pain 2021; 22:71. [PMID: 34261435 PMCID: PMC8278743 DOI: 10.1186/s10194-021-01281-z] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/22/2021] [Indexed: 12/27/2022] Open
Abstract
Background Primary headache disorders are common and burdensome conditions. They are associated to several comorbidities, such as cardiovascular or psychiatric ones, which, in turn, contribute to the global burden of headache. The aim of this study is to provide a comprehensive description of the pooled prevalence of comorbidities of primary headache disorders using a meta-analytical approach based on studies published between 2000 and 2020. Methods Scopus was searched for primary research (clinical and population studies) in which medical comorbidities were described in adults with primary headache disorders. Comorbidities were extracted using a taxonomy derived from the Global Burden of Disease (GBD) study. We compared prevalence of comorbidities among headache sufferers against general population using GBD-2019 estimates, and compared comorbidities’ proportions in clinical vs. population studies, and by age and gender. Results A total of 139 studies reporting information on 4.19 million subjects with primary headaches were included: in total 2.75 million comorbidities were reported (median per subject 0.64, interquartile range 0.32–1.07). The most frequently addressed comorbidities were: depressive disorders, addressed in 51 studies (pooled proportion 23 %, 95 % CI 20–26 %); hypertension, addressed in 48 studies (pooled proportion 24 %, 95 % CI 22–26 %); anxiety disorders addressed in 40 studies (pooled proportion 25 %, 95 % CI 22–28 %). For conditions such as anxiety, depression and back pain, prevalence among headache sufferers was higher than in GBD-2109 estimates. Associations with average age and female prevalence within studies showed that hypertension was more frequent in studies with higher age and less females, whereas fibromyalgia, restless leg syndrome, and depressive disorders were more frequent in studies with younger age and more female. Conclusions Some of the most relevant comorbidities of primary headache disorders – back pain, anxiety and depression, diabetes, ischemic heart disease and stroke – are among the most burdensome conditions, together with headache themselves, according to the GBD study. A joint treatment of headaches and of these comorbidities may positively impact on headache sufferers’ health status and contribute to reduce the impact of a group of highly burdensome diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-021-01281-z.
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Affiliation(s)
| | - Manuela Deodato
- Department of Life Sciences, University of Trieste, Trieste, Italy. .,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Micaela Robotti
- Centro di Diagnosi e Cura delle Cefalee, Palazzo della Salute, Gruppo San Donato, Milano, Italy.,PainClinicMilano, Centro Medico Visconti di Modrone, Milano, Italy
| | | | - Valeria Pozzilli
- Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Cristina Galati
- UO Neuropsichiatria Infantile, Policlinico Universitario Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy
| | - Giovanna Nocera
- UO Neuropsichiatria Infantile, Policlinico Universitario Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy
| | - Eleonora De Matteis
- Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Gioacchino De Vanna
- Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy
| | - Emanuela Fellini
- Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Gleni Halili
- Department of Neurology, University Hospital Center 'Mother Teresa', Tirana, Albania
| | - Daniele Martinelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Gabriele Nalli
- Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Serena Serratore
- Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Irene Tramacere
- Dipartimento di Ricerca e Sviluppo Clinico, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Roma, Italy.,Regional Referral Headache Center, Sant'Andrea University Hospital, Roma, Italy
| | - Alberto Raggi
- UOC Neurologia, Salute Pubblica, Disabilità, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
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