Widespread pain symptoms and psychological distress in southern Chinese with orofacial pain

Abstract

The study investigated the experience of widespread pain (WP) symptoms and psychological distress in southern Chinese with orofacial pain (OFP). A community-based, cross-sectional case-control study involving people aged 35-70 registered with the Hospital Authority/University of Hong Kong Family Medicine Clinic served as the sampling frame. People with recent OFP symptoms and a group without OFP took part. Standard questions were asked about OFP conditions in the previous month. Psychological status was evaluated through depression, and non-specific physical symptoms (NPS) scores were measured with depression and somatization sub-scales of the Symptom Checklist-90. Widespread pain was determined using body outline drawings to identify painful sites prior to a standard clinical examination. Two hundred people with OFP and 200 without OFP participated. Compared with 5·0% in the comparison group (P = 0·005), 13·5% of participants with OFP had WP (OFP/WP). Multiple OFP symptoms were more common in the OFP/WP sub-group than the OFP sub-group without WP (OFP/No WP) (P < 0·002). Sixty-three percent of the OFP/WP sub-group had moderate/severe depression scores compared with 26·0% in the OFP/No WP sub-group (P < 0·001). When pain items were included and excluded, 92·6% and 88·9% of the OFP/WP sub-group had moderate/severe NPS scores, respectively compared with 68·5% and 65·0% in the OFP/No WP sub-group (P = 0·004). Co-morbid WP occurred relatively often in southern Chinese with OFP. Psychological distress was common in OFP sufferers, particularly those with WP. A multidisciplinary approach to treatment including cognitive/behavioural therapy should be considered in Chinese people with OFP as part of a WP pattern. © 2009 Blackwell Publishing Ltd.