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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Depressive illness may affect the patient's response to dental care. It has been implicated both as a causal factor and a sequela in facial pain syndromes. Depression is treated with various medications that may influence function and health of the oral cavity and that may adversely interact with drugs used to control pain and anxiety.
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PMID:Recognition and management of the depressed dental patient. 4 Oct 14

Atypical facial pain is generally an unclearly defined pain syndrome. We tested in 35 patients (31 women, 4 men) with a mean age of 53.2 +/- 14.9 years and a chronic facial pain syndrome the quality of the new diagnostic criteria of the International Headache Society (IHS), at the same time using the SCL-90-R (Self-Report Symptom Inventory), to identify any associated psychopathology. In accordance with the literature there is a marked female preponderance, an altogether vague description of symptoms and a long history of incorrect diagnoses. Of note is the high number of invasive procedures (3.5 +/- 3.0). In agreement with the IHS commentary, an operation or injury to the face was a suspected cause in 43%. In contrast to the IHS criteria, we found in our patient sample dysaesthesia (63%), bilateral occurrence (37%), remission periods (57%), pain attacks (23%) and presence of superficial as well as deep pain. Depression is by no means the only psychopathological abnormality in atypical facial pain; a broad spectrum of complaints is seen. The IHS classification appears insufficient to separate atypical facial pain from other primary headache and facial pain syndromes. We therefore suggest a modified version of the IHS criteria for atypical facial pain.
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PMID:[Atypical facial pain--quality of IHS (International Headache Society) criteria and psychometric data]. 143 49

This study investigated how specific expressive behaviors (verbal report of pain level and the frequency of emitting specific non-verbal facial expressions of pain) may change over the course of a chronic pain condition. Based on the concept of chronic pain behaviors, we hypothesized that both verbal and non-verbal behavior would increase with duration of pain. Thirty-six women with chronic temporomandibular disorder (TMD) pain (duration over 6 months) were compared with 35 recent onset cases (first episode, duration < or = 2 months). Subjects completed questionnaires assessing depression, anxiety, somatization, daily hassles and pain coping strategies. They were videotaped during a resting baseline and 2 painful conditions: experimental cold pressor pain and the clinically relevant pain of palpation of the masticatory muscles and temporomandibular joint; tapes were coded for facial expression using the Facial Action Coding System. Visual analog scale (VAS) ratings of the aversiveness and intensity of ongoing TMD pain were collected at baseline, and similar ratings of cold pressor and clinical examination pain were gathered after the painful stimulus. Recent onset and chronic cases did not differ on self-report measures of anxiety, depression, somatization or daily stress. Coping strategies were also similar, although chronic cases showed a greater tendency to catastrophize. Self-report measures of ambient facial pain, as well as the pain of clinical examination and cold pressor stimulation, revealed no significant differences between the 2 groups. In contrast, rates of pain facial expression were significantly higher for chronic cases under all conditions of the experiment, including baseline.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of temporomandibular disorder pain duration on facial expressions and verbal report of pain. 149 56

Descriptive data are presented for 100 patients reporting facial pain and temporomandibular dysfunction (TMD) precipitated by (1) overt facial/head trauma, (2) "whiplash" injury, and (3) "whiplash" injury with overt trauma. Analysis of the data suggests that these TMD trauma subsets are significantly different in terms of total number of pain sites, presence of concomitant neck pain, range of opening, and report of sleep disturbance and involvement in litigation. They also varied with respect to reducing and nonreducing disc displacement. However, significant differences were not observed for initial pain at presentation; muscle pressure pain threshold; McGill affective or HSCL-90 depression, anxiety, and somatization scores; prior pain duration; or time post-trauma before pain onset. These findings suggest that patients within these trauma categories share some common characteristics but may differ in important demographic, pain, and temporomandibular joint dysfunction variables.
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PMID:Symptom characteristics in TMD patients reporting blunt trauma and/or whiplash injury. 181 67

The outcome of treatment for trigeminal neuralgia was evaluated in 145 patients treated with cryotherapy, 265 patients treated with radiofrequency thermocoagulation and 65 patients treated with microvascular decompression. Median duration of pain relief was 6 months after cryotherapy and 24 months after thermocoagulation. Sixty-two per cent of patients were pain-free 5 years after decompression. When pain recurred after cryotherapy it affected the same sites as previously in 80% of patients. Repeated cryotherapy of mental and long buccal nerves, but not of infra-orbital nerves, gave more prolonged pain relief than initial cryotherapy. One third of cryotherapy and thermocoagulation patients had atypical facial pain after treatment. Psychometric testing suggested that levels of anxiety and depression were similarly reduced after the three treatment methods. Outcome data should be used to help new patients make informed choices about their treatment.
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PMID:Cryotherapy for trigeminal neuralgia: a 10 year audit. 191 83

Chronic facial pain syndromes are associated with high levels of distress and depression. Immune system measures were investigated in otherwise healthy patients suffering from chronic temporomandibular pain and dysfunction syndrome (TMPDS) and in matched controls. No mean differences were found between TMPDS patients and the controls on any of the immune measures; however, both ConA and PWM responses in TMPDS patients were decreased in relation to the level of demoralization (P less than 0.05). Cognitive symptoms such as low self-esteem and perceptions of helplessness/hopelessness were implicated in these effects. In addition, among patients pain severity was independently associated with decreased ConA response (P less than 0.05). The data suggest possible correlates of stress-induced changes in the immune system.
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PMID:Facial pain, distress, and immune function. 208 80

Studies undertaken over the past ten years have demonstrated that stress and depression can induce immune alterations, including decreased numbers of immunocompetent cells and impaired lymphocyte and natural killer cell activity. Factors such as age and severity of symptomatology influence these effects. The substantial stress and depression associated with chronic pain syndromes and the evidence for opioid involvement in immunomodulation suggest that immune system changes may occur in some patients with chronic facial pain.
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PMID:Psychoneuroimmunology: potential relevance to chronic orofacial pain. 208 5

Temporomandibular joint (TMJ) disorders have been collectively grouped as myofascial pain-dysfunction syndrome (MPDS) or temporomandibular joint dysfunction syndrome (TMJDS). In the past, these terms have been used synonomously to describe a set of clinical signs and symptoms that include pain in the TMJ and muscles of mastication, limited or deviant opening of the mandible, and/or joint sounds. The present study segregated two major subgroups subsumed within this diagnostic classification and assigned them to a myogenic facial pain (MFP) group and a TMJ internal derangement (TMJID) group. Previous studies may have included both of these disorders as MPDS/TMJDS. While some signs and symptoms are similar, the primary differentiation is based on meniscus displacement present with TMJID patients and pain distribution patterns between the two groups. While MFP/TMJID patients comprise the majority of the facial pain population, a third major group of patients is encountered, being classified under the diagnostic appellation of atypical facial pain (AFP). Patients with AFP usually complain of vague and wandering pain in the maxilla or mandible; however, no identifiable source of infection or organic disease can be uncovered. One hundred fifty patients seeking consultation and care for facial pain met the criteria for inclusion into one of three clinical groups. The groups were compared for age, sex, duration of symptoms, bruxism and/or clenching habits, and disturbed sleep patterns. Differences in surface electromyographic levels from the facial and cervical muscles were also examined. Minnesota Multiphasic Personality Inventory (MMPI) scores from 95 subjects were compared with self-report measures of depression and anxiety. It was concluded that subcategorization of myofascial pain dysfunction patients into a MFP and TMJID group is justified on the basis of psychometric differences, clenching habits, masseter EMG levels, and male:female ratio. Furthermore, psychopathological factors are more significant among MFP and AFP subjects than TMJID patients.
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PMID:Comparison of clinical characteristics in myogenic, TMJ internal derangement and atypical facial pain patients. 213 94

Conditions in which antidepressants have been used include diabetic neuropathy, postherpetic neuralgia, headaches, arthritis, chronic back pain, cancer, thalamic pain, facial pain, and phantom limb pain. Although much of the available information is derived from inadequately controlled trials, it seems that antidepressants provide analgesia in many of these disorders. The analgesic effects tend to be independent of antidepressant effects, and doses of heterocyclic antidepressants used for analgesia seem to be lower than those considered effective in the treatment of depression. Doses should be started low and gradually increased until the patient reaches the highest tolerable dose. Onset of analgesia is variable, ranging from 1 day to 10 weeks. Common side effects include dry mouth, drowsiness, urinary retention, orthostatic hypotension, and constipation. Optimum dosages and schedules have not been established.
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PMID:Antidepressants in the management of chronic pain syndromes. 214 20

Patients with chronic pain are often depressed, and antidepressants have been widely used in the treatment of these patients. Well controlled clinical studies have shown that antidepressants have analgesic effects, apparently independent of changes in mood, and in lower doses than used in the treatment of depression. Good results have been reported for several types of chronic pain, especially headache and facial pain, arthritis, fibromyalgia and neuralgias. In addition, antidepressants have also an indirect analgesic action by relieving a depressive condition associated with chronic pain.
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PMID:[Do antidepressive agents have analgesic effects?]. 221 95


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