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Biomedical subjects

R I Brooke

Publications and source records attributed to R I Brooke.

At least 19 recordsLinked to original sources
PubMed1997

The cortisol response to psychological stress in temporomandibular dysfunction.

The salivary cortisol response to psychological stress and its relationship to psychological variables was examined in 36 female temporomandibular dysfunction (TMD) sufferers and 39 female control participants. Saliva samples were taken at baseline, after completion of a modified version of the Trier Social Stress Test, and after rest. Participants also completed a battery of measures, including Visual Analog Scales for measuring pain intensity and disability and a number of established psychological scales. The TMD group showed a significantly higher cortisol response to experimental stress than the control group. Closer examination of the data revealed that the TMD group was heterogeneous and composed of a group that hypersecreted cortisol in response to stress (Hi-SC TMD group) and another group whose cortisol response was not significantly different from the control group (Lo-SC TMD group). The Lo-SC TMD group showed significant negative relationships between cortisol response and self-reported symptoms of both anxiety and depression, plus significantly more use of the Praying or Hoping coping strategy on the Coping Strategies Questionnaire. A dual relationship between TMD symptoms and the stress response is proposed. First, a biological predisposition to TMD is suggested by the stress response in the Hi-SC TMD group. Second, both psychological and biological variables appear to be important factors in those TMD patients who respond to stress with low cortisol secretion.

Adaptation, Psychological↗
PubMed1993

Atypical odontalgia. Its aetiology and prognosis.

Atypical odontalgia is a chronic pain disorder in which persistent pain develops in clinically normal teeth. Its possible aetiology and long-term prognosis are discussed. Suggested management regimes are reviewed.

Adult↗
PubMed1992

Atypical odontalgia. Update and comment on long-term follow-up.

The purpose of the present study is to update the reader on atypical odontalgia and to present some preliminary data on the long-term follow-up of a subsample (n = 28) of these patients. Data based on 120 patients tend to support earlier findings that indicate that primarily women (81%) between the ages of 23 and 60 have this condition. Pain is generally localized in the teeth but may involve several areas of the oral cavity. On the basis of this larger sample size, the relationship between atypical odontalgia and migraine does not appear to be as strong as initially reported. Psychologic disturbance also may play a less significant role than initially thought. Follow-up data on 28 patients suggest that many patients will continue to experience episodes of pain. Antidepressant medication still appears to be the treatment of choice for this condition.

Adolescent↗
PubMed1991

Are there psychologic predictors of treatment outcome in temporomandibular joint pain and dysfunction?

This study explores the relationship between diverse psychologic factors and treatment outcome in temporomandibular joint pain and dysfunction (TMJPD). During assessment, 178 patients with TMJPD were given a pressure pain threshold and tolerance task and completed the Basic Personality Inventory, the Illness Behavior Questionnaire, the Multidimensional Health Locus of Control, the Perceived Stress Scale, and the Ways of Coping Checklist. Subjects also answered questions pertaining to TMJPD symptomatology, including chronicity and severity. After conservative treatment with simple jaw exercises and ultrasound, patients were contacted again at 5 months to complete a follow-up questionnaire package similar to the initial questionnaire battery. Percent reduction in average pain intensity and perceived TMJPD severity were used as outcome criteria. The data were analyzed with discriminant function analyses. One hundred patients responded to the follow-up questionnaire. Patients who reported more than a 50% reduction in average pain intensity tended to be less inclined to accept responsibility for their problems and were slightly better able to distance themselves from their problems than the less improved groups. Those who reported more than a 50% reduction in TMJPD severity indicated that the condition was not associated with an identifiable onset event and that the condition had become moderately worse between onset and first seeking help.

Adaptation, Psychological↗
PubMed1989

Screening for psychiatric illness in patients with oral dysesthesia by means of the General Health Questionnaire--twenty-eight item version (GHQ-28) and the Irritability, Depression and Anxiety Scale (IDA).

Thirty-one consecutive subjects suffering from oral dysesthesia and without detectable organic disease were seen in a university outpatient dental clinic. They were assessed with a screening test for psychiatric illness, the General Health Questionnaire, 28-item version (GHQ-28). Twelve subjects also completed the Irritability, Depression and Anxiety Scale (IDA). At the 4/5 cutoff on the GHQ, 51.9% of the patients showed evidence of psychiatric illness. The IDA appeared to be more sensitive than the GHQ-28 in terms of detecting psychiatric illness, especially depression, and 75% of the 12 subjects who completed both scales were found to be depressed on the IDA. These results were compared to results obtained by another cross-sectional study of different types of pain clinics in which the same scales were used to screen for psychiatric illness. The subjects with oral dysesthesia as measured by the IDA appeared to have psychiatric illness more often than the other subjects with chronic pain, except those attending a psychiatric clinic. The GHQ-28 results on the other hand showed less psychiatric illness in the latter group. Our findings indicate that psychiatric illness, especially depression, may play an important role in this disorder and that the IDA may be more sensitive than the GHQ for detecting depression.

Adult↗
PubMed1988

Long-term prognosis for the clicking jaw.

Ninety-four patients who complained of clicking of the temporomandibular joint not associated with pain were followed up for varying lengths of time. Analysis of the follow-up indicates that approximately 70% of the patients who have a painless, clicking temporomandibular joint will eventually have pain and that the use of a nonrepositioning occlusal splint does not lessen the likelihood of pain ensuing.

Female↗
PubMed1987

Screening for psychiatric morbidity. The pattern of psychological illness and premorbid characteristics in four chronic pain populations.

Three hundred and seventy-eight patients from 4 chronic pain populations have been examined by self-assessment questionnaire methods to estimate the amount of psychiatric morbidity present. Using the General Health Questionnaire-28 scaled version (GHQ-28) the findings for probable psychiatric illness by clinic were: for anaesthetists' pain clinics serving a mixed urban and rural population--37%; for an oral medicine facial pain clinic--30%; for a rural hospital pain clinic--37%; and for a psychiatrists' pain assessment and treatment service--51%. These findings demonstrate the effects of selection upon the psychiatric characteristics of different pain populations. On the subscales of the General Health Questionnaire the psychiatric clinic patients were significantly more depressed than those in the other 3 groups (P less than 0.001) and also showed more social dysfunction (P less than 0.001). On the Irritability/Depression and Anxiety Questionnaire (IDA), depression and inward irritability were higher in the psychiatric clinic patients (P less than 0.001) but the amount of anxiety did not differ by clinic or by diagnosis (P greater than 0.05). These findings are taken to indicate that the extent of somatic complaints and anxiety does not differentiate the majority of pain patients in pain services with psychological illness from others attending for treatment. However, in the patients who have definite psychological symptoms, depression, social dysfunction and irritability provide a characteristic pattern. The psychiatric clinic patients were demonstrably more introverted or obessional on the Hysteroid/Obsessoid Questionnaire (HOQ) than those in other clinics. Childhood experience as seen by the patients did not differ by clinic or diagnosis and did not correlate significantly with personality as measured by the HOQ. It did correlate very significantly with measures of the current mood represented by the IDA. This effect was relatively weak, permitting the inference that the major portion of those psychological abnormalities which were found to be present was related to other factors such as the occurrence of painful lesions.

Adult↗
PubMed1986

Temporomandibular pain and dysfunction syndrome: the relationship of clinical and psychological data to outcome.

A prospective study of 60 patients with the temporomandibular pain and dysfunction syndrome (TMPDS) was done using the General Health Questionnaire, the Crown-Crisp Experiential Index, and the Parental Bonding Instrument. Three months after an initial visit 59 patients were reassessed: 18 patients were completely better or improved a lot, 27 were improved a little, and 14 were the same or worse. Patients' outcomes were not related to the severity or duration of symptoms at the initial presentation. Thirty-five percent of the patients had not received any therapy in the 3-month interval. The outcomes of these patients were not different from the outcomes of patients who had received treatment. A significant relationship was found between initial psychological test scores and outcome (multivariate F = 3.80, P less than 0.05). This relationship was curvilinear: the group with the worst outcomes scored highest, that with the best outcomes scored in the middle, and that with intermediate outcomes scored lowest. These results imply that mild psychological distress may facilitate a successful outcome, whereas either excessive psychological disturbance or minimal psychological complaint is associated with poor results.

Adult↗
PubMed1984

The treatment of temporomandibular joint syndrome through control of anxiety.

Following a negative experience with general anesthesia, a 20-yr-old woman developed anxiety and an inability to relax concomitant with temporomandibular joint dysfunction and pain syndrome. Systematic countering of anxiety by relaxation successfully removed her anxiety and led to a complete resolution of her symptoms. Follow-up at 16 months indicated maintenance of treatment gains and no recurrence of the symptoms during the previous 12 months.

Adult↗
PubMed1984

An unusual case of oral pigmentation.

Pigmentation of the oral mucosa may be a sign of underlying systemic disease. An unusual case of what appeared clinically as mucosal pigmentation was shown eventually to be minocycline-related pigmentation of the underlying alveolar bone. If this manifestation of bone discoloration is recognized, unnecessary investigation may be avoided.

Adult↗
PubMed1983

Is the temporo-mandibular pain and dysfunction syndrome a disorder of the mind?

It was assumed that patients with temporo-mandibular pain and dysfunction syndrome (TMPDS) would represent a population whose pain resulted from their emotional state. It was anticipated in the light of existing reports in the literature that they would score like patients with anxiety neurosis or other psychiatric illness on the General Health Questionnaire (GHQ) and the Crown-Crisp Experiential Index (CCEI: a measure of anxiety and other emotional characteristics). It was also anticipated that patients with facial pain associated with lesions would show evidence of similar emotional disturbance secondary to their pain. It was postulated, however, that the TMPDS patients would be separated from the others by a scale which measured their attitudes to parents and childhood experience, namely, the Parental Bonding Instrument (PBI). The actual comparison of TMPDS patients and patients with facial pain and lesions or pathophysiological disorders showed little evidence of neuroticism in either group; nor were the parental bonding attitudes found to be abnormal. It is questioned whether TMPDS is primarily psychological in origin.

Adult↗