淺談顳顎關節障礙症（TMDs）的心理因素及心理治療

Discussion on Psychological Factors and Psychotherapies for Temporomandibular Disorders (TMDs)

本文旨在探討顳顎關節障礙（temporomandibular disorders, TMDs）的臨床特徵、多元病因以及非藥物治療。TMDs是涉及咀嚼肌肉和顳顎關節疼痛、功能障礙的臨床狀況。目前國人發生率高達20%，但求診率卻不到10%。TMDs不僅影響生理健康，還對身心健康和生活品質造成負面影響。基於生理心理社會疾病模型的觀點，本文探討TMDs的多元病因，強調心理因素在疾病發展中的重要性。介紹認知行為治療（cognitive behavioural therapy, CBT）和生理回饋治療兩種心理治療方式，CBT通過調整負向信念和行為模式來幫助患者管理症狀，而生理回饋治療則透過使用生理數據和放鬆技巧來減輕生理反應和情緒。本文強調綜合關注生理、心理和社會因素來進行治療，同时提倡心理治療在TMDs管理中的重要性，以實現對TMDs患者的有效治療和改善生活品質的目標。

This article aims to explore the clinical characteristics, multifactorial etiology, and non-pharmacological treatments of temporomandibular disorders (TMDs). TMDs are clinical conditions involving pain and dysfunction of the masticatory muscles and temporomandibular joints. The incidence rate among the population is as high as 20%, yet the consultation rate is less than 10%. TMDs affect not only physical health but also mental health and quality of life. Based on the biopsychosocial illness model, this article discusses the multifactorial etiology of TMDs, emphasizing the importance of psychological factors in disease development. It particularly introduces two psychological therapies: cognitive behavioural therapy (CBT) and biofeedback therapy. CBT helps patients manage symptoms by adjusting negative beliefs and behavior patterns, while biofeedback therapy reduces physiological responses and emotions through physiological data and relaxation techniques. This article highlights the importance of a comprehensive approach that addresses physiological, psychological, and social factors in treatment, advocating for the role of psychological therapy in the management of TMDs to achieve effective treatment and improve the quality of life for TMDs patients.