Short- and long-term efficacy of brief cognitive-behavioral therapy for patients with chronic temporomandibular disorder pain: A randomized, controlled trial

被引:197
作者
Turner, JA [1 ]
Mancl, L
Aaron, LA
机构
[1] Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA
[2] Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA
[3] Univ Washington, Sch Dent, Dept Dent Publ Hlth Sci, Seattle, WA 98195 USA
[4] Univ Washington, Sch Dent, Dept Oral Med, Seattle, WA 98195 USA
关键词
cognitive-behavioral therapy; temporomandibular disorders; chronic pain; brief psychotherapy; randomized controlled trial;
D O I
10.1016/j.pain.2005.11.017
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We evaluated the short- and long-term efficacy of a brief cognitive-behavioral therapy (CBT) for chronic temporomandibular disorder (TMD) pain in a randomized controlled trial. TMD clinic patients were assigned randomly to four sessions of either CBT (n = 79) or all education/attention control condition (n = 79). Participants completed outcome (pain, activity interference, jaw function, and depression) and process (pain beliefs, catastrophizing, and coping) measures before randomization, and 3 (post-treatment), 6, and 12 months later. As compared with the control group, the CBT group showed significantly greater improvement across the follow-ups oil each outcome, belief, and catastrophizing measure (intent-to-treat analyses). The CBT group also showed a greater increase in use of relaxation techniques to cope with pain, but not in use of other coping strategies assessed. On the primary outcome Measure, activity interference, the proportion or patients who reported no interference at 12 months was nearly three times higher in the CBT group (35%,) than in the control group (13%) (P = 0.004). In addition, more CBT than control group patients had clinically meaningful improvement in pain intensity (50% versus 29% showed >= 50% decrease, P = 0.01), masticatory jaw function (P < 0.001), and depression (P = 0.016) at 12 months (intent-to-treat analyses). The two groups improved equivalently oil a measure of TMD knowledge. A brief CBT intervention improves one-year clinical outcomes of TMD clinic patients and these effects appear to result from specific ingredients of the CBT. (c) 2005 International Association for the Study of Pain Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:181 / 194
页数:14
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