Association between temporomandibular disorders with anxiety and depression: a cross-sectional study

Aims: Temporomandibular disorders (TMDs) are multifactorial conditions influenced by biological and psychosocial factors. In this study, postgraduate dental students were evaluated for TMD. Anxiety and depression were analyzed in relation to TMD. Methods: In this cross-sectional study, data were obtained from 214 postgraduate dental students. TMD severity was determined using the Fonseca Anamnestic Index (FAI). Levels of anxiety and depression were obtained with the Hospital Anxiety and Depression Scale (HADS). Differences between groups were analyzed using the Mann–Whitney U test and the chi-square test. Relationships among continuous variables were explored with Spearman correlation analysis. Multivariable logistic regression was applied to identify factors associated with TMD. The discriminative ability of the model was evaluated by receiver operating characteristic (ROC) curve analysis. Results: TMD were identified in 68.7% of the participants. Individuals with TMD exhibited significantly higher anxiety scores compared with those without TMD (p<0.001). In contrast, depression scores did not differ significantly between the two groups (p=0.063). Anxiety and depression scores showed a strong positive correlation (ρ=0.654, p<0.001). Multivariable logistic regression analysis indicated that anxiety was independently associated with TMD (OR=1.30; 95% CI: 1.14-1.48; p<0.001). Gender was also significantly related to TMD (OR=0.45; 95% CI: 0.23-0.87; p=0.018). Depression did not emerge as an independent predictor. The regression model showed acceptable discriminative performance (AUC=0.743). Conclusion: Anxiety was independently associated with TMD among postgraduate dental students, whereas depression was not significant after adjustment. These findings support a biopsychosocial perspective and emphasize early anxiety identification for TMD prevention.