INFLUENCE OF PSYCHOLOGICAL-FACTORS ON THE RESPONSE TO CLOMIPRAMINE INHOSPITALIZED CHRONIC LOW-BACK-PAIN PATIENT - PRELIMINARY DATA FROM A PSYCHOMETRIC STUDY

Background: Chronic low back pain is a complex condition produced by m ultiple factors, Psychological disturbances have been found in previou s studies using a variety of psychological tests, The most widely used self-administered questionnaire was the Minnesota Multiphasic Persona lity Inventory (MMPI), Objective: to assess the response to clomiprami ne in chronic low back pain patients according to baseline MMPI scores , Patients and Methods: thirty chronic low back pain patients were giv en clomipramine intravenously during a ten-day hospital stay then oral ly for 20 days, The dose was gradually brought up to 150 mg/d, The MMP I was administered on the day before treatment initiation, MMPI scores were not looked at until the end of the study The Saint Antoine Quest ionnaire, a visual analog scale for pain, Schober's maneuver, and the global result as assessed by the patients (success or failure) were ev aluated on days 0 (DO), 4 (D4), 10 (D10), and 30 (D30), Results: the i nitial mean MMPI scores for hypochondria, depression, and hysteria wer e significantly lower in the 23 patients (76%) who considered their tr eatment successful on D30, Among the 13 patients with high hypochondri a and hysteria scores, five improved during hospitalization then had a relapse after returning home, Conclusion: the response to treatment w ith clomipramine was better in nondepressive patients, The hypochondri a and hysteria scores were the best predictors of the response to clom ipramine. These results may provide a basis for selecting those chroni c low back pain patients most likely to benefit from clomipramine ther apy.