Relationships between temporomandibular disorders, msd conditions, and mental health comorbidities: Findings from the veterans musculoskeletal disorders cohort

Brenda T. Fenton, Joseph L. Goulet, Matthew Bair, Terrie Cowley, Robert D. Kerns

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective. Temporomandibular disorders (TMDs) have been associated with other chronic painful conditions (e.g., fibromyalgia, headache) and suicide and mood disorders. Here we examined musculoskeletal, painful, and mental health comorbidities in men vs women veterans with TMD (compared with non-TMD musculoskeletal disorders [MSDs] cases), as well as comorbidity patterns within TMD cases. Design. Observational cohort. Setting. National Veterans Health Administration. Subjects. A cohort of 4.1 million veterans having 1=MSDs, entering the cohort between 2001 and 2011. Methods. Chi-square tests, t tests, and logistic regression were utilized for cross-sectional analysis. Results. Among veterans with any MSD, those with TMD were younger and more likely to be women. The association of TMD with race/ethnicity differed by sex. Odds of TMD were higher in men of Hispanic ethnicity (OR=1.38, 95% CI = 1.271.48) and nonwhite race/ethnicity other than black or Hispanic (OR=1.29, 95% CI = 1.161.45) compared with white men. Odds of TMD were significantly lower for black (OR=0.54, 95% CI = 0.490.60) and Hispanic women (OR=0.84, 95% CI = 0.730.995) relative to white women. Non-MSD comorbidities (e.g., irritable bowel syndrome, mental health, headaches) were significantly associated with TMD in male veterans; their pattern was similar in women. Veterans with back pain, nontraumatic joint disorder, or osteoarthritis had more MSD multimorbidity than those with TMD. Conclusions. Complex patterns of comorbidity in TMD cases may indicate different underlying mechanisms of association in subgroups or phenotypes, thereby suggesting multiple targets to improve TMD. Longitudinal comprehensive studies powered to look at sex and racial/ethnic groupings are needed to identify targets to personalize care.

Original languageEnglish (US)
Pages (from-to)S61-S68
JournalPain Medicine (United States)
Volume19
DOIs
StatePublished - Sep 1 2018

Fingerprint

Temporomandibular Joint Disorders
Veterans
Comorbidity
Mental Health
Hispanic Americans
Veterans Health
United States Department of Veterans Affairs
Headache Disorders
Fibromyalgia
Irritable Bowel Syndrome
Chi-Square Distribution
Back Pain
Mood Disorders
Osteoarthritis
Suicide
Headache
Longitudinal Studies
Cross-Sectional Studies
Joints
Logistic Models

Keywords

  • Central Sensitization
  • Comorbidity
  • Headache
  • Musculoskeletal Disorders
  • Painful Conditions
  • Temporomandibular Disorders

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Relationships between temporomandibular disorders, msd conditions, and mental health comorbidities : Findings from the veterans musculoskeletal disorders cohort. / Fenton, Brenda T.; Goulet, Joseph L.; Bair, Matthew; Cowley, Terrie; Kerns, Robert D.

In: Pain Medicine (United States), Vol. 19, 01.09.2018, p. S61-S68.

Research output: Contribution to journalArticle

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abstract = "Objective. Temporomandibular disorders (TMDs) have been associated with other chronic painful conditions (e.g., fibromyalgia, headache) and suicide and mood disorders. Here we examined musculoskeletal, painful, and mental health comorbidities in men vs women veterans with TMD (compared with non-TMD musculoskeletal disorders [MSDs] cases), as well as comorbidity patterns within TMD cases. Design. Observational cohort. Setting. National Veterans Health Administration. Subjects. A cohort of 4.1 million veterans having 1=MSDs, entering the cohort between 2001 and 2011. Methods. Chi-square tests, t tests, and logistic regression were utilized for cross-sectional analysis. Results. Among veterans with any MSD, those with TMD were younger and more likely to be women. The association of TMD with race/ethnicity differed by sex. Odds of TMD were higher in men of Hispanic ethnicity (OR=1.38, 95{\%} CI = 1.271.48) and nonwhite race/ethnicity other than black or Hispanic (OR=1.29, 95{\%} CI = 1.161.45) compared with white men. Odds of TMD were significantly lower for black (OR=0.54, 95{\%} CI = 0.490.60) and Hispanic women (OR=0.84, 95{\%} CI = 0.730.995) relative to white women. Non-MSD comorbidities (e.g., irritable bowel syndrome, mental health, headaches) were significantly associated with TMD in male veterans; their pattern was similar in women. Veterans with back pain, nontraumatic joint disorder, or osteoarthritis had more MSD multimorbidity than those with TMD. Conclusions. Complex patterns of comorbidity in TMD cases may indicate different underlying mechanisms of association in subgroups or phenotypes, thereby suggesting multiple targets to improve TMD. Longitudinal comprehensive studies powered to look at sex and racial/ethnic groupings are needed to identify targets to personalize care.",
keywords = "Central Sensitization, Comorbidity, Headache, Musculoskeletal Disorders, Painful Conditions, Temporomandibular Disorders",
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T1 - Relationships between temporomandibular disorders, msd conditions, and mental health comorbidities

T2 - Findings from the veterans musculoskeletal disorders cohort

AU - Fenton, Brenda T.

AU - Goulet, Joseph L.

AU - Bair, Matthew

AU - Cowley, Terrie

AU - Kerns, Robert D.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Objective. Temporomandibular disorders (TMDs) have been associated with other chronic painful conditions (e.g., fibromyalgia, headache) and suicide and mood disorders. Here we examined musculoskeletal, painful, and mental health comorbidities in men vs women veterans with TMD (compared with non-TMD musculoskeletal disorders [MSDs] cases), as well as comorbidity patterns within TMD cases. Design. Observational cohort. Setting. National Veterans Health Administration. Subjects. A cohort of 4.1 million veterans having 1=MSDs, entering the cohort between 2001 and 2011. Methods. Chi-square tests, t tests, and logistic regression were utilized for cross-sectional analysis. Results. Among veterans with any MSD, those with TMD were younger and more likely to be women. The association of TMD with race/ethnicity differed by sex. Odds of TMD were higher in men of Hispanic ethnicity (OR=1.38, 95% CI = 1.271.48) and nonwhite race/ethnicity other than black or Hispanic (OR=1.29, 95% CI = 1.161.45) compared with white men. Odds of TMD were significantly lower for black (OR=0.54, 95% CI = 0.490.60) and Hispanic women (OR=0.84, 95% CI = 0.730.995) relative to white women. Non-MSD comorbidities (e.g., irritable bowel syndrome, mental health, headaches) were significantly associated with TMD in male veterans; their pattern was similar in women. Veterans with back pain, nontraumatic joint disorder, or osteoarthritis had more MSD multimorbidity than those with TMD. Conclusions. Complex patterns of comorbidity in TMD cases may indicate different underlying mechanisms of association in subgroups or phenotypes, thereby suggesting multiple targets to improve TMD. Longitudinal comprehensive studies powered to look at sex and racial/ethnic groupings are needed to identify targets to personalize care.

AB - Objective. Temporomandibular disorders (TMDs) have been associated with other chronic painful conditions (e.g., fibromyalgia, headache) and suicide and mood disorders. Here we examined musculoskeletal, painful, and mental health comorbidities in men vs women veterans with TMD (compared with non-TMD musculoskeletal disorders [MSDs] cases), as well as comorbidity patterns within TMD cases. Design. Observational cohort. Setting. National Veterans Health Administration. Subjects. A cohort of 4.1 million veterans having 1=MSDs, entering the cohort between 2001 and 2011. Methods. Chi-square tests, t tests, and logistic regression were utilized for cross-sectional analysis. Results. Among veterans with any MSD, those with TMD were younger and more likely to be women. The association of TMD with race/ethnicity differed by sex. Odds of TMD were higher in men of Hispanic ethnicity (OR=1.38, 95% CI = 1.271.48) and nonwhite race/ethnicity other than black or Hispanic (OR=1.29, 95% CI = 1.161.45) compared with white men. Odds of TMD were significantly lower for black (OR=0.54, 95% CI = 0.490.60) and Hispanic women (OR=0.84, 95% CI = 0.730.995) relative to white women. Non-MSD comorbidities (e.g., irritable bowel syndrome, mental health, headaches) were significantly associated with TMD in male veterans; their pattern was similar in women. Veterans with back pain, nontraumatic joint disorder, or osteoarthritis had more MSD multimorbidity than those with TMD. Conclusions. Complex patterns of comorbidity in TMD cases may indicate different underlying mechanisms of association in subgroups or phenotypes, thereby suggesting multiple targets to improve TMD. Longitudinal comprehensive studies powered to look at sex and racial/ethnic groupings are needed to identify targets to personalize care.

KW - Central Sensitization

KW - Comorbidity

KW - Headache

KW - Musculoskeletal Disorders

KW - Painful Conditions

KW - Temporomandibular Disorders

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