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MMPI Profile as an Outcome "Predictor" in the Treatment of Noncancer Pain Patients Utilizing Intraspinal Opioid

D M Doleys1, J Brown

  • 1Pain and Rehabilitation Institute, Birmingham, Alabama.

Neuromodulation : Journal of the International Neuromodulation Society
|December 14, 2011
PubMed

Insights

Minnesota Multiphasic Personality Inventory (MMPI) profiles may not predict outcomes for intrathecal opioid therapy. Patients with more "normal" pretreatment profiles showed less pain reduction, suggesting a need for comprehensive patient selection criteria.

Area of Science:

  • Pain Management
  • Psychological Assessment
  • Neurosurgery

Background:

  • Chronic non-cancer pain affects millions, often requiring multimodal treatment approaches.
  • Intrathecal opioid therapy offers an alternative for refractory pain, but patient selection remains a challenge.
  • Psychological factors can influence treatment outcomes in chronic pain patients.

Purpose of the Study:

  • To investigate changes in Minnesota Multiphasic Personality Inventory (MMPI) profiles before and after intrathecal opioid therapy.
  • To determine if MMPI profiles can predict treatment success in patients with chronic non-cancer pain.
  • To explore the relationship between MMPI profile changes and pain reduction following intrathecal opioid therapy.

Main Methods:

  • A cohort of 30 patients with chronic non-cancer pain received intrathecal opioid therapy via a drug administration system (DAS).
  • Patients underwent MMPI assessments pre-treatment and post-treatment.
  • Data on pain duration, previous surgeries, and opioid dosage were collected and analyzed.

Main Results:

  • Patients were categorized into "positive change" and "negative change" groups based on MMPI profile shifts.
  • The "negative change" group, with more "normal" pretreatment MMPI profiles, experienced less pain reduction and higher opioid use.
  • A positive change in MMPI profile correlated with greater pain reduction.

Conclusions:

  • The MMPI profile alone may not be a reliable predictor of long-term outcomes for intrathecal opioid therapy.
  • Patients with initially more "normal" MMPI profiles did not achieve outcomes as favorable as those with more elevated profiles.
  • Comprehensive patient selection, integrating MMPI results with clinical evaluation and other assessments, is recommended for optimizing intrathecal opioid therapy outcomes.

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