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Predicting Persistent Orofacial Pain: The Role of Illness Perceptions, Anxiety, and Depression

Lookup NU author(s): Dr Chris PenlingtonORCiD, Professor Vera Araujo-SoaresORCiD, Professor Justin DurhamORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Sage Publications, Inc., 2019.

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INTRODUCTION: Persistent orofacial pain (POFP) can be caused by a range of conditions affecting the mouth and face and is often associated with significant disability. Biopsychosocial factors are known to be important predictors and have not yet been fully explored in this population. OBJECTIVES: This study aimed to explore whether Illness perceptions and psychological distress (anxiety and depression) could predict long-term outcome in a community based sample of patients receiving routine care for persistent orofacial pain (POFP). METHODS: A longitudinal cohort design study assessed 198 patients recruited from primary or secondary healthcare settings on 5 separate occasions over a 2 year period. Outcome was measured by the Graded Chronic Pain Scale and dichotomised into good or poor outcome categories. Independent variables included subscale scores of the psychometrically shortened Illness Perception Questionnaire (IPQ-PR) and the Patient Health Questionnaire-4 (PHQ-4, assessing anxiety and depressive symptomatology). Logistic regressions were performed to test whether scores on each subscale would be associated with different outcome for patients at 12 and 24 months and overall. RESULTS: Beliefs about Consequences predicted outcome category (good vs poor) above and beyond other illness perception subscales, anxiety and depressive symptomatology (z=3.78, p<0.000, OR 3.05 95%CI 1.71 – 5.43). Both depressive symptomatology, measured by the PHQ-2 (p=.001 OR 4.06 95%CI 1.74 – 9.52) and psychological distress (mixed anxiety and depression, p=.029 OR 2.88 95%CI 1.12 – 7.41) measured by the PHQ-4 were also predictive of poor outcome, however these effects were no longer significant once measures of Illness perceptions were added. CONCLUSION: Beliefs about the consequences of POFP are important predictors of outcome independent of other variables and can easily and briefly be included in assessments to inform management decisions.

Publication metadata

Author(s): Penlington C, Araujo-Soares V, Durham J

Publication type: Article

Publication status: Published

Journal: JDR Clinical & Translational Research

Year: 2019

Volume: 5

Issue: 1

Pages: 40-49

Print publication date: 01/01/2020

Online publication date: 07/05/2019

Acceptance date: 04/04/2019

Date deposited: 05/04/2019

ISSN (print): 2380-0844

ISSN (electronic): 2380-0852

Publisher: Sage Publications, Inc.


DOI: 10.1177/2380084419846447


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