The specific aims grow out of our previous case/control and longitudinal study of psychosocial factors in the course of a chronic pain disorder, the temporomandibular pain and dysfunction syndrome (TMPDS).
The aims center on unresolved questions about the extent and nature of the relationships between a specific chronic pain syndrome of unknown origin and depression. In our previous study of 151 TMPDS cases and 139 well controls, one striking finding was the much higher level of psychological distress observed in the pain cases by contrast with the controls. In a separate pilot study on a sample of 20 of these cases, a psychiatrist and clinical psychologist conducted rigorous research diagnostic interviews and made diagnoses of DSM-III-R psychiatric disorders, including past and current major depression. It is the high rate of major depression that they found that provides the point of departure for the proposed research. We now propose to conduct two interviews with a new and larger sample of 160 cases and 160 controls and 320 of their first degree relatives. The first interview, conducted by psychiatrists and clinical psychologists, would assess rates of major depression and other DSM-III-R disorders in probands and all their adult first degree relatives by interviewing probands and one of their first degree relatives. The second interview, conducted by masters level health professionals, would assess family history of chronic pain symptoms and serious physical illnesses in probands and all their adult first degree relatives by interviewing probands and one of their adult first degree relatives by interviewing probands and one of their first degree relatives. Rates of depression and pain in subgroups of depressed vs. nondepressed pain patients and controls will be examined to elucidate the temporal relationship between pain and depression. Plans for statistical analyses include calculation of odds ratios to assess the comorbidity of TMPDS and major depression, and logistic regression to predict case status from the presence of pain disorders and/or major depression in first degree relatives.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Project (R01)
Project #
5R01DE005989-08
Application #
3219706
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1982-07-01
Project End
1995-02-28
Budget Start
1992-03-01
Budget End
1993-02-28
Support Year
8
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Columbia University (N.Y.)
Department
Type
Schools of Public Health
DUNS #
064931884
City
New York
State
NY
Country
United States
Zip Code
10027
Raphael, K G; Marbach, J J; Klausner, J (2000) Myofascial face pain. Clinical characteristics of those with regional vs. widespread pain. J Am Dent Assoc 131:161-71
Raphael, K G; Marbach, J J (2000) Comorbid fibromyalgia accounts for reduced fecundity in women with myofascial face pain. Clin J Pain 16:29-36
Raphael, K G; Marbach, J J; Gallagher, R M et al. (1999) Myofascial TMD does not run in families. Pain 80:15-22
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Marbach, J J (1999) Medically unexplained chronic orofacial pain. Temporomandibular pain and dysfunction syndrome, orofacial phantom pain, burning mouth syndrome, and trigeminal neuralgia. Med Clin North Am 83:691-710, vi-vii
Marbach, J J; Ballard, G T; Frankel, M R et al. (1997) Patterns of TMJ surgery: evidence of sex differences. J Am Dent Assoc 128:609-14
Raphael, K G; Marbach, J J (1997) When did your pain start?: reliability of self-reported age of onset of facial pain. Clin J Pain 13:352-9
Marbach, J J (1996) Orofacial phantom pain: theory and phenomenology. J Am Dent Assoc 127:221-9
Marbach, J J (1996) Temporomandibular pain and dysfunction syndrome. History, physical examination, and treatment. Rheum Dis Clin North Am 22:477-98
Marbach, J J (1996) Phantom tooth pain: differential diagnosis and treatment. J Mass Dent Soc 44:14-8

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