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CONTROVERSY IN CHRONIC LOW BACK PAIN RESEARCH: THE COMBINED USE OF THE SYMPTOM CHECKLIST-90-REVISED AND THE ROLAND MORRIS DISABILITY QUESTIONNAIRE DOES NOT CONFIRM THE SUGGESTED RELATIONSHIP BETWEEN PSYCHOSOCIAL DISTRESS AND SELF-REPORTED DISABILITY



Abstract

Background Context. In the assessment and treatment of patients with chronic low back pain (CLBP) the bio- psycho-social model is used world wide. Psychological distress has been reported to have a strong relationship with self reported disability. The relationship between psychosocial distress measured with the SCL-90-R and self reported disability measured with the RMDQ has not been investigated.

Purpose. To analyze the relationship between psychosocial distress measured with the Symptom Checklist-90-Revised (SCL-90-R) and self reported disability measured with the Roland Morris Disability Questionnaire (RMDQ) in patients with CLBP.

Study design/Setting. This cross sectional study was performed in an outpatient pain rehabilitation setting.

Patient sample. The study sample consisted of 152 patients with CLBP.

Outcome measures. Scores on SCL-90-R and the RMDQ.

Methods. All patients admitted for multidisciplinary treatment completed the SCL-90-R and RMDQ prior to treatment. Pearson’s correlation coefficients between SCL-90-R (Global Severity Index and subscales) and RMDQ were calculated.

Results. Correlation coefficients between SCL-90-R (Global Severity Index and subscales) and RMDQ ranged from 0.18 to 0.31 (p< 0.05).

Conclusion. The relationship between psychosocial distress measured with the SCL-90-R and self reported disability measured with the RMDQ in CLBP patients is weak. For clinical practice it is important to unravel the components and their suggested relationships in the bio-psycho-social model. This research has demonstrated that these relationships cannot be confirmed with the combined use of the SCL-90-R and the RMDQ. Further research is needed to determine which combination of instruments is most suitable to use in clinical practice, and to confirm or refute the suggested impact of psychosocial distress on self reported disability.

Correspondence should be addressed to Mr J. O’Dowd, Honorary Secretary at SBPR c/o BOA, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE.