Gender differences in psychopathologic features of temporomandibular disorders

Epidemiologic literatures suggest that temporomandibular joint disorders (TMD) are more prevalent in women than in men. The role of gender in TMD is likely multifactorial involving inherent physiological differences in gonadal hormones, stress reactivity, and inflammatory responses, as well as sociocultural differences in response to pain. Aim: to examine whether there is a gender-dependent risk profile for psychopathologic features (depression, non-specific physical symptoms, and graded chronic pain according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II) in a TMD population sample. Materials and methods: A sample of 308 (61 men and 247 women; mean age, 41 years) consecutive patients from a TMD clinic completed the Research Diagnostic Criteria for TMD (RDC/TMD) Axis II questionnaire. Axis II consents the psycho-social diagnosis in four reference values: 1) chronic pain grade classification subdivided in: grade 0 (no TMD pain in prior 6 months); grade I (low disability, low intensity); grade II (low disability, high intensity); grade III (high disability, moderately limiting); grade IV (high disability, severely limited); 2) score of depression (normal, moderate, severe); 3) score of somatization (nonspecific physical symptoms: normal, moderate, severe); 4) functional limitation. Results: Graded chronic pain: 26% of the women has degree I, 36.4% degree II, 17% degree III, 9.7% degree IV. 34.4% of the men has degree I, 32.8% degree II, 6.5% degree III, 3.3% degree IV. Depression: 14.1% of the woman has a moderate depression and 56% severe. 9.8% of the men has a moderate depression and 39.3% severe. Somatization: 23.9% of the women has a moderated somatization, 58% severe; 32.8% men have moderated somatization, 31.1% severe. Conclusions: Within the limitations of this study, female patients diagnosed with TMD has higher levels of depression and somatization than male patients. It was concluded that gender differences play a role in etiopathogenesis of TMD, as demonstrated by an increase in levels of depression and somatization in female patients