The role of psychosocial variables in physician judgement of pain-related disability

Abstract

Objective: The current study aimed to determine the extent to which physicians take psychosocial factors into account when making pain-related judgements of disability. Subjects and Method: 228 chronic pain patients completed the West Haven-Yale Multidimensional Pain Inventory (WHYMPI), while 69 completed both this instrument and the Addiction Potential, Anxiety, Health Concerns and Depression supplementary subscales of the Minnesota Multiphasic Personality Inventory – 2 (MMPI-2). Physicians were required to provide diagnoses, as well as ratings of functional ability for each patient. Hierarchical regression analyses were conducted in order to determine the degree to which psychosocial variables predicted physician ratings of patient functional ability. Results: Psychosocial variables were found to predict physician assessments of patients’ level of occupational functioning, general satisfaction with life and physician perceptions of the role that psychosocial their risk of analgesic dependence. Depression and anxiety symptoms predicted factors played in patients’ pain experiences. Health concerns were predictive of physician assessments of analgesic dependence amongst patients. Conclusion: While certain psychosocial factors appear to be considered by physicians during pain-related disability assessment, psychiatric symptoms and physical pathology seem to weigh heavier in the process.

Key Words: Disability, functional ability, chronic pain, psychosocial, psychopathology, health concerns, WHYMPI, MMPI-2