PERSONALITY-TRAITS, PAIN DURATION AND SEVERITY, FUNCTIONAL IMPAIRMENT, AND PSYCHOLOGICAL DISTRESS IN PATIENTS WITH PERSISTENT LOW-BACK-PAIN

The relationships between psychological distress, pain duration, neuro ticism, extraversion, pain severity, and functional impairment were ex amined in a large group of patients with persistent complaints of low back pain. We evaluated patients on a host of relevant variables befor e treatment and at 1 year and 2 years after treatment which permitted assessment of the stability of the relationships over time. We found t hat the levels of psychological distress reported by patients were not related to the duration of their complaint. Rather, levels of psychol ogical distress are related to both aspects of the patients' personali ties, and characteristics of their illness. Patients who scored high o n neuroticism reported higher levels of psychological distress than pa tients who scored low on this trait. Similarly, patients who had more severe pain and were more functionally impaired also reported higher l evels of psychological distress due to pain. The relative strengths of these relationships varied with treatment status. Before treatment, p sychological distress and neuroticism were strongly related, but after treatment, the relationship was moderate. In contrast, the relationsh ip of psychological distress to pain severity and functional impairmen t was significantly strengthened after treatment. We attributed this s hift in the relative strengths of the relationships to change in the p atient perception of their illness. (C) 1997 International Association for the Study of Pain. Published by Elsevier Science B.V.