Psychological effects of brace therapy on patients with idiopathic scoliosis

Abstract

To examine the psychological effects of brace treatment for idiopathic scoliosis, we performed separate retrospective and prospective studies. In the retrospective study, 50 female patients with idiopathic scoliosis and 50 healthy control subjects without scoliosis were given the Maudsley personality inventory (M test). This test assesses personality in terms of emotional response to stress, and an introversion/extroversion score (E) and a neuroticism score (N) are calculated. The percentage of individuals with psychological abnormalities according to the M test results that is, those whose results for both the E and N scores were either below or above the normal range (divided into four groups, according to scores, as E⁻N⁻type, E⁻N⁺, E⁺N⁻, and E⁺N⁺) was markedly higher in the group receiving brace treatment than in the group receiving non-brace treatment or the control group. In the prospective study of 44 adolescent girls with idiopathic scoliosis, chronological changes in the results of the M test revealed a greater shift from the normal type to abnormal type in the brace therapy group than in the non-brace therapy group. Brace therapy places a tremendous psychological stress on young adults. The results of this study indicate that any pre-existing psychological problems in the patient need to be considered before a brace is used. The use of the M test in patients receiving brace therapy is useful for evaluating the psychological effects and helping to prevent patients stopping brace use. We continue brace therapy in subjects whose personality type is rated as normal or E⁺N⁻ type. However, in subjects whose personality type is E⁻N⁻, E⁻N⁺, or E⁺N⁺ type, we take measures to reduce the psychological effects by offering conseling or permitting part-time brace wearing.