Chapman S L, Pemberton J S
Emory University School of Medicine, Atlanta, Georgia.
Clin J Pain. 1994 Dec;10(4):267-76. doi: 10.1097/00002508-199412000-00005.
The aim of this study was to assess the ability of specific and clinically relevant Minnesota Multiphasic Personality Inventory (MMPI) profile types to predict outcomes in a structured interdisciplinary pain-management program for patients with low back pain.
Subjects were divided into clusters representing MMPI profiles yielding similar clinical interpretation. Analyses of variance and chi-square testing assessed the effect of cluster group on a variety of outcome measures at pretreatment, posttreatment, and 6- to 66-month follow-up. Fisher's Least Significant Difference Test assessed the significance of differences between pairs of cluster groups.
A university-based comprehensive interdisciplinary pain-management program serving both inpatients and outpatients.
122 subjects with chronic low back pain who completed the program, provided follow-up data, and fit into the definition of one of seven clusters.
Self-reports of subjective pain intensity, pain-related medication intake, and activity level at pretreatment, posttreatment, and follow-up; employment status at pretreatment and follow-up.
Cluster groups did not differ significantly at any time on activity level and medication intake and differed on employment status only at pretreatment. There was a significant (p < 0.05) effect of cluster group on subjective pain intensity, but only two pairwise group comparisons were significant: subjects with a normal MMPI profile and those with no elevations except T = 71-80 on Hypochondriasis and Hysteria reported less pain at follow-up than did subjects with extreme elevations (T > 80) on both Hypochondriasis and Hysteria.
Even when subjects with chronic pain are divided into cluster groups associated with highly similar clinical interpretations, the MMPI for the most part fails to predict self-reported outcomes in an interdisciplinary pain-management program.
本研究旨在评估特定且具有临床相关性的明尼苏达多相人格调查表（MMPI）剖面图类型对腰痛患者结构化跨学科疼痛管理项目结局的预测能力。
将受试者分为代表具有相似临床解释的MMPI剖面图的组群。方差分析和卡方检验评估组群对治疗前、治疗后以及6至66个月随访时各种结局指标的影响。Fisher最小显著差异检验评估组群对之间差异的显著性。
一个基于大学的综合跨学科疼痛管理项目，服务住院患者和门诊患者。
122名慢性腰痛患者，他们完成了该项目，提供了随访数据，且符合七个组群之一的定义。
治疗前、治疗后及随访时主观疼痛强度、与疼痛相关的药物摄入量和活动水平的自我报告；治疗前和随访时的就业状况。
组群在活动水平和药物摄入量方面在任何时间均无显著差异，仅在治疗前就业状况存在差异。组群对主观疼痛强度有显著（p < 0.05）影响，但只有两组两两比较具有显著性：MMPI剖面图正常的受试者以及除疑病和癔症量表T分在71 - 80之间无升高外其他量表无升高的受试者在随访时报告的疼痛比疑病和癔症量表T分均极端升高（T > 80）的受试者少。
即使将慢性疼痛患者分为具有高度相似临床解释的组群，MMPI在很大程度上仍无法预测跨学科疼痛管理项目中的自我报告结局。
