Avaliando Dissociação em Pacientes com Transtornos Craniomandibulares

Uso de Ansiolíticos e Antidepressivos

  • Omar Franklin Molina MDS, PA, Post Doct in Orofacial Pain, Professor and Researcher, UNIRG, Gurupi-TO, Brazil;
  • Zeila Coelho Santos MDS in Orthodontics, Specialist in Orofacial Pain, Professor of Orofacial Pain, UNIRG, Gurupi-TO, Brazil;
  • Bruno Huber Simião DDS, MDS, Professor and Researcher in Prosthodontics, UNIRG, Gurupi-TO, Brazil;
  • Rogério Ferreira Marquezan MDS, Psychologist, Research Dean, UNIRG, Gurupi-TO, Brazil;
  • Ricardo Léllis Marçal DDS, MDS, Professor of Restorative Dentistry, UNIRG, Gurupi-TO, Brazil;
  • Juliana Romanelli Marçal DDS, MDS, Professor, Researcher Restorative Dentistry/Orofacial Pain, UNIRG, Gurupi-TO, Brazil;
  • Márllos Peres de Melo MDS, Statistician and Researcher, UNIRG, Gurupi, TO, Brazil.
Palavras-chave: Transtornos Craniomandibulares, Dissociação, Ansiolíticos, Antidepressivos

Resumo

Objetivo. Apresentar método de classificação, avaliar frequência, grau de dissociação em pacientes com Distúrbios craniomandibulares e dissociação e verificar uso de ansiolíticos e antidepressivos. Método. Exame clínico, gravidade do bruxismo e a Escala de Experiência de Dissociação, foram aplicados em 243 indivíduos com DCMs e 43 controles. Os indivíduos com DCM e controles foram classificados como portadores de dissociação, ausente, leve, moderada, grave e mui­to grave. Resultados. Os indivíduos com DCM apresentaram mais dissociação do que aqueles sem (73,3% e 30,2% respectivamente e p=0.0001. Os pacientes com graus leve (55%) e moderados (24,2%) foram mais frequentes do que aqueles de graus grave (11,8%) e muito grave (9%). Os indivíduos com DCMs e dissociação usaram mais an­siolíticos do que aqueles sem dissociação (31%) usaram mais ansiolíti­cos do que aqueles sem dissociacáo (4,6% , p=0.03). Os pacientes com DCMs e dissociação (62%) não usaram mais antidepressivos do que aqueles sem dissociação (40%, p=0.32), mas apresentaram maior uso de antidepressivos do que o grupo controle (62% e 8,3%, p=0,0001). Uso de ansiolíticos e antidepressivos aumentou com a gravidade da dissociação (p=0.009 e p=0.04). Conclusão. A frequência de dis­sociação foi maior no grupo DCM, a dissociação leve e moderada ocorreram mais frequentemente do que a grave e muito grave. Os ansiolíticos foram usados mais frequentemente no grupo DCM com dissociação do que nos grupos DCM sem dissociação e controle.

Métricas

Carregando métricas...

Referências

Fantoni F, Salvetti G, Manfredini D, Bosco M. Current concepts on the functional somatic syndromes and temporomandibular disorders. Stomatol Baltic Dental Maxillofac J 2007;9:3-9.

Barsky AS, Borus JF. Functional somatic syndromes. Ann Intern Med 1999;130;910-21. http://dx.doi.org/10.7326/0003-4819-130-11-199906010-00016

Fillingim RB. Individual differences in pain responses. Curr Rheumatol Rep 2005;7:342-8. http://dx.doi.org/10.1007/s11926-005-0018-7

Rudy TE, Turk DC, Kubinski JA, Zaki HS. Differential treatment responses of TMD patients as a function of psychological characteristics. Pain 1995;61:103-12. http://dx.doi.org/10.1016/0304-3959(94)00151-4

Zaidner E, Sewell RA, Murray E, Schiller A, Price B, Cunningham M. Case report; New-onset dissociative identity disorder after electroconvulsive therapy. McLean Annals Behav Neurol 2006;1:10-14.

Fisher J. Dissociative phenomena in the everyday lives of trauma survivors. Paper Presented at The Boston University Medical School of Psychological Trauma. Congress, May 2001, p.1-22.

Vega BR, Liria AF, Pérez CB. Trauma, dissociation and somatization. Annuary of Clin Health Psychol 2005;1:27-38.

Molina OF, Peixoto M, Santos ZC, Penoni J, Aquilino R, Peixoto MA. Bruxism as a mechanism subserving hysteria: A new theory. Rev Neurocienc 2008;16:262-68.

Ross CA, Norton GR, Wozney K. Multiple personality disorder: an analysis of 236 cases. Can J Psychiatry 1989;34:413-8.

Molina OF, Tavares P, Aquilino R, Rank R, Santos ZC, César EW, et al. Depression, pain and site: a clinical comparison study in mild, moderate, severe and extreme bruxers. Rev Neurocienc 2007;15:10-9.

Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease 1986;174:727-35. http://dx.doi.org/10.1097/00005053-198612000-00004

Öztürk E, Sar V. Somatization as a predictor of suicidal ideation in dissociative disorders. Psychiat Clin Neurosci 2008;62:662-8. http://dx.doi.org/10.1111/j.1440-1819.2008.01865.x

Baker D, Hunter ED, Lawrence E, Medford N, Patel M, Senior C, et al. Depersonalization disorder: clinical features of 204 cases. Brit J Psychiat 2003;182:428-33. http://dx.doi.org/10.1192/bjp.182.5.428

Kluft RP. Current issues in dissociative identity disorders. Bridging Eastern Western Psychiat 2003;1:71-87.

Gatchel JR, Garofalo JP, Ellis E, Holt C. Major psychological disorders in a cute and chronic TMD. An initial examination. JADA 1996;127:1365-74.

Saheeb BD & Oktapoor AN. Co-morbid psychiatric disorders in Nigerian patients suffering temporomandibular joint pain and dysfunction. Nigerian J Clin Pract 2005;8:23-8.

Yap AU, Dworkin SF, Chua EK, List T, Tan KB, Tan HH. Prevalence of temporomandibular disorder subtypes, psychological distress and psychological dysfunction in Asian patients. J Orofac Pain 2003;17:21-8.

Coe MT Dalenberg CJ, Aransky KM, Reto CS. Adult attachment styles, reported childhood violence history and types of dissociative experiences. Dissociation 1995,8:142-54.

Michelotti A, Martina R, Russo M, Romeo R. Personality characteristics of temporomandibular disorder patients using the MMPI. J Craniomand Pract 1998;16:119-25.

Franklin J. Diagnosis of covert and subtle forms of multiple personality disorder. Dissociation 1988; 1:27-33.

Atlas G, Fine CG, Kluft RP. Multiple personality disorder misdiagnosed as mental retardation. Dissociation 1988;1:77-83.

Chu JA. On the misdiagnosis of multiple personality disorder. Dissociation 1991;4:200-4.

Espirito-Santo H, Pio-Abreu L. Psychiatric symptoms and dissociation in conversion, somatization and dissociative disorders. Royal Aust New Zealand Coll Psychiat 2009;43:270-6. http://dx.doi.org/10.1080/00048670802653307

Sar V, Akyüz G, Dogan O. Prevalence of dissociative disorders among women in the general population. Psychiatry Res 2007;149:169-76. http://dx.doi.org/10.1016/j.psychres.2006.01.005

Mai F. Somatization disorder: A practical review Can J Psychiat 2004;49:652-62.

Kluft RP. Treatment of multiple personality disorder. Psychiat Clin North Amer 1984;7:121-34.

Abbas A. Somatization: Diagnosing it sonner through emotion-focused interviewing. J Fam Pract 2005;54:215-24.

Braun BG. Unusual medication regimes in the treatment of dissociative disorder patients. Dissociation 1990; 3:144-50.

Coons PPM. Psychophysiologic aspects of multiple personality disorder: a review. Dissociation 1988;1:47-53.

Fink D. Reflections on the psychotherapy of a patient with multiple personality disorder. Jefferson J Psychiat 1987;5:34-9.

Galbraith PM, Neubauer PJ. Underwriting considerations for dissociative disorders. J Insur Med 2000;32:71-8.

Waldie KE., Poulton R. Physical and psychological correlates of primary headaches in young adulthood: A 26 year longitudinal study. J Neurol Neurosurg Psychiatry 2002;72:86-92. http://dx.doi.org/10.1136/jnnp.72.1.86

Mueller L. Psychological aspects of chronic headache. JAOA 2000;100:14-21. 34.Boon S, Draijer N. The differentiation of patients with MPD or DDNOs from patients with cluster B personality disorders. Dissociation 1993;6:126-35.

Gentile JP, Dillon KS, Gilly PM. Psychiatric and pharmacotherapy for patients with dissociative identity disorders. Innovat Clin Neurosci 2013;10:22-9.

Publicado
2013-09-30
Como Citar
Molina, O. F., Santos, Z. C., Simião, B. H., Marquezan, R. F., Marçal, R. L., Marçal, J. R., & Melo, M. P. de. (2013). Avaliando Dissociação em Pacientes com Transtornos Craniomandibulares. Revista Neurociências, 21(3), 369-376. https://doi.org/10.34024/rnc.2013.v21.8157
Seção
Artigos Originais