PSYCHOLOGICAL EVALUATION OF PATIENTS WITH ACUTE AND CHRONIC LOW-BACK-PAIN IN COMPARISON WITH ASYMPTOMATIC INDIVIDUALS

Purpose: As a result of its increasing incidence and social medical im plications, low back pain with either chronic or acute symptoms presen ts a major challenge for our society. The psychological background of pain perception and valuation has been explored in various studies; fr equently, no positive correlation was found between subjective pain pe rception and structural orthopedic findings. Method: A symptoms checkl ist (SCL-90-R) was used to compare a group of patients hospitalized be cause of low back pain with a group of asymptomatic controls. Addition ally, the pain-specific questionnaire (ERSS) was employed to verify th e validity of the depressive mood scale by means of the corresponding scale in the SCL-90-R. Results: When the SCL-90-R was given to both gr oups, significant differences could be observed between the patients a nd the controls on the scales for somatisation, depressive mood, anxie ty, phobias and psychoticism. Moreover, patients with chronic pain had higher scores on the scales for phobias and the global marker of ''po sitive symptom total'' (PST) than patients with acute back pain. On th e scales for somatisation and insecurity during social contacts, women reported higher levels of psychological distress than men. Age-relate d differences were not observed. The depressive mood scale of the ERSS appears to be valid. With the SCL-90-R we could demonstrate significa nt differences between patients with acute and chronic pain, and betwe en the sexes. No differences were found in the age-group comparison. C onclusion: In patients with low back pain, psychological parameters ha ve to be taken into account in any comprehensive concept of conservati ve treatment.