Psychological dimensions of pain in patients with rheumatoid arthritis, fibromyalgia syndrome, and chronic low back pain

Abstract

Objective: To evaluate psychological dimensions of pain and to identify any correlation between pain duration and psychological symptomatology in chronic pain patients. Methods: A shortened version of the Minnesota Multiphasic Personality Inventory was administered to 45 patients with fibromyalgia syndrome [FMS], 40 patients with chronic low back pain [CLBP], 20 patients with rheumatoid arthritis [RA] and the results were compared with data from 30 demographically-matched healthy normal controls [HNC]. Results: The patients in all three chronic pain groups derived significantly higher scores on the neurotic scales [hypochondriasis, depression and hysteria] than did subjects in the HNC group [P < 0.05]. The "Conversion V pattern" was observed in the FMS and CLBP groups while the descending pattern was seen in the RA group. The patients who were disabled for four or more years showed more depression in the FMS groups and more hypochondriasis in the CLBP group [P < 0.05]. Conclusion: Neurotic symptoms are found to be common in all three groups of patients. The pattern of the psychological disturbances appears to change with increasing duration of pain. If psychological support is effective in reducing disability, it should be invoked at an early stage for patients with chronic pain. © 2002 by The Haworth Press, Inc. All rights reserved.