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Integration of Mental Health Screening in the Management of Temporomandibular Disorders (TMD)

Research output: Contribution to journalArticlepeer-review

Elizabeth Yeung, Ahmad K Abou-Foul, Faith Alexandra Elisabeth Matcham, Timothy William John Poate, Kathy Fan

Original languageEnglish
JournalBritish Journal of Oral and Maxillofacial Surgery
Early online date28 Apr 2017
Accepted/In press22 Mar 2017
E-pub ahead of print28 Apr 2017


King's Authors


Common mental health disorders (CMD) such as anxiety and/or depression are reported ≥16-40% patients who suffer from Temporomandibular Disorders (TMD) against 16.3% in the general population. Failure to recognise CMD may be detrimental to the management of TMD. Paper-based screening tools have been reported in TMD, but require clinician assessment and subsequent collation of data.
We present our findings of a new system – IMPARTS (Integrating Mental and Physical: Research Training and Services) – allowing the use of validated tools with treatment protocols to identify patients who may benefit from psychological intervention. IMPARTS also monitors disease and treatment progress.
Patients attending outpatient clinics with symptoms of TMD completed a questionnaire of validated screening tools on an electronic tablet: Generalised Anxiety Disorder questionnaire (GAD-7), Patient Health Questionnaire (PHQ-9). Inclusion of Oral Health Impact Profile (OHIP-14) and Brief Pain Inventory (BPI) allowed treatment monitoring. Data collection and analysis linked directly into the electronic patient record. Results could be reviewed immediately during consultation with treatment suggestion – e.g. referral to liaison psychiatry.
162 patients were included. 17.3% (n=28) screened positively for probable Major Depressive Disorder and 19.8% (n=32) for Generalised Anxiety Disorder requiring referral. 1.2% (n=2) were identified high risk of suicide/self-harm and recommended immediate psychological assessment.
Patient-completed electronic screening tools with clearly defined protocols can aid holistic treatment of TMD through identification, risk stratification and appropriate referral of patients with CMD.

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