Journal of Occupational Rehabilitation

, Volume 3, Issue 2, pp 95–103 | Cite as

Prevalence of psychopathology in acute and chronic low back pain patients

  • Regina K. Kinney
  • Robert J. Gatchel
  • Peter B. Polatin
  • W. Tom Fogarty
  • Tom G. Mayer
Article

Abstract

This study assessed the differential prevalence rates of psychopathology in chronic and acute low back pain patients. Psychopathology was assessed with the Structured Clinical Interview for the DSM-III-R (SCID). The results showed that chronic low back pain patients (n=90), had much higher rates of psychopathology than did patients in the acute back pain group (n=90), and much higher than general population base rates. In particular, chronic low back pain patients had high rates of major depression, substance abuse, and personality disorders. Moreover, the chronic low back patients also had high rates of premorbid psychopathology. It was concluded that psychopathology is a major concomitant of chronic low pack pain, and that treating the psychological problems, along with the physical aspects of the chronic low back pain may increase the patient's chance of a successful therapeutic outcome.

Key Words

psychopathology chronic low back pain DSM-III-R 

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References

  1. 1.
    Fishbain DA, Goldberg M, Meagher BR, Steele R, Rosomoff H. Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria.Pain 1986; 26: 181–197.PubMedGoogle Scholar
  2. 2.
    Reich J, Tupin JP, Abramowitz SI. Psychiatric diagnosis of chronic pain patients.Am J Psychiat 1983; 140: 1495–1498.PubMedGoogle Scholar
  3. 3.
    Polatin BP, Kinney RK, Gatchel RJ, Lillo E, Mayer TG. Psychiatric illness and chronic low back pain: The mind and the spine-which goes first.Spine 1993; 18: 66–71.PubMedGoogle Scholar
  4. 4.
    American Psychiatric Association.Diagnostic and statistical manual of mental disorders (3rd Ed., revised). Washington, D.C.: American Psychiatric Association, 1987.Google Scholar
  5. 5.
    Katon W, Egan K, Miller D. Chronic pain: Lifetime psychiatric diagnoses and family history.Am J Psychiat 1985; 142: 1156–1160.PubMedGoogle Scholar
  6. 6.
    Large RG, DSM-III diagnoses in chronic pain: Confusion or clarityJ Nerv Ment Dis 1986; 174: 295–303.PubMedGoogle Scholar
  7. 7.
    Coste J, Paolaggi JB, Spira A. Classification of nonspecific low back pain. I. Psychological involvement in low back pain.Spine 1991; 17: 1028–1037.Google Scholar
  8. 8.
    Spitzer RL, Williams JBW, Gibbon M, First MB.Structured clinical interview for DSM-III-R. New York: New York State Psychiatric Institute, 1988.Google Scholar
  9. 9.
    Skre I, Onstad S, Torgersen S, Kringlen E. Higher interrater reliability for the Structured Clinical Interview for DSM-III-R Axis I (SCID-I).Acta Psychiat Scand 1991; 84: 167–173.PubMedGoogle Scholar
  10. 10.
    Williams, JBW, Gibbon M, First MB, Spitzer RL, Davies M, Borus J, Howes MF, Kane J, Pope HG, Rounsaville B, Wittchen HU. The structured clinical interview for DSM-III-R (SCID) II: Multi-site test-retest reliability.Arch Gen Psychiat (in press).Google Scholar
  11. 11.
    Robins, LN, Helzer JE, Weissman MM, Orvaschel DA, Gruenberg E, Burke JD, Regier DA. Lifetime prevalence of specific psychiatric disorders in three sites.Arch Gen Psychiat 1984; 41: 949–958.PubMedGoogle Scholar
  12. 12.
    Regier DA, Boyd JH, Burke JD, Rae DS, Myers JK, Kramer M, Robins LN, George LK, Karno M, Locke BZ. One-month prevalence of mental disorders in the United States.Arch Gen Psychiat 1988; 45: 977–986.PubMedGoogle Scholar
  13. 13.
    Zimmerman M, Coryell W. DSM-III personality disorder diagnoses in a nonpatient sample: Demographic correlates and comorbidity.Arch Gen Psychiat 1989; 46: 682–689.PubMedGoogle Scholar
  14. 14.
    Gatchel RJ, Baum A, Krantz D.Introduction to health psychology (2nd Ed.), New York: Random House, 1988.Google Scholar
  15. 15.
    Fleiss, JL,Statistical methods for rates and proportions. New York: John Wiley & Sons, 1981.Google Scholar
  16. 16.
    Gatchel RJ. Early development of physical and mental deconditioning in painful spinal disorders. In Mayer TG, Mooney V, Gatchel RJ, eds.Contemporary conservative care for painful spinal disorders. Philadelphia: Lea and Febiger, 1991.Google Scholar
  17. 17.
    Lustman PJ, Velozo CA, Eubanks B, Montag JA, Cole DM. Prior psychiatric problems in rehabilitation clients with work-related injuries.J. Occup Rehab 1991; 1: 227–233.Google Scholar

Copyright information

© Plenum Publishing Corporation 1993

Authors and Affiliations

  • Regina K. Kinney
    • 1
  • Robert J. Gatchel
    • 1
  • Peter B. Polatin
    • 1
  • W. Tom Fogarty
    • 2
  • Tom G. Mayer
    • 3
  1. 1.Department of PsychiatryUniversity of Texas, Southwestern Medical Center at DallasDallas
  2. 2.Occupational Health CentersDallas
  3. 3.Department of Orthopedic SurgeryUniversity of Texas, Southwestern Medical Center at DallasDallas

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