Gray I C, Main C J, Waddell G
Clin Orthop Relat Res. 1985 Apr(194):258-63.
The importance of psychologic distress and illness behavior is well recognized in low-back pain but has rarely been studied in other orthopedic conditions. Psychologic and clinical assessment of 100 patients undergoing elective surgery for minor leg conditions or joint replacement for osteoarthritis or rheumatoid arthritis showed surprisingly little psychologic distress or illness behavior, particularly when compared with 235 patients with low-back pain. The most striking finding was that in low-back pain there was a close relation between psychologic disturbance and failed surgery, but the nonspinal patients showed a complete absence of such a relation. This type of psychologic assessment is neither necessary nor helpful in the routine management of most clearly defined, nonspinal, correctly managed orthopedic conditions.
心理困扰和患病行为在腰背痛中的重要性已得到充分认识，但在其他骨科疾病中却很少被研究。对100例因小腿轻微疾病接受择期手术或因骨关节炎或类风湿关节炎接受关节置换的患者进行的心理和临床评估显示，令人惊讶的是，心理困扰或患病行为很少，尤其是与235例腰背痛患者相比。最显著的发现是，在腰背痛患者中，心理障碍与手术失败之间存在密切关系，但非脊柱疾病患者却完全不存在这种关系。这种心理评估在大多数明确界定、非脊柱、管理得当的骨科疾病的常规管理中既不必要也无帮助。
