Chronic pain and the questionable use of the Minnesota Multiphasic Personality Inventory

Several studies have observed that patients who complain of chronic pain have significantly elevated scores on the first 3 clinical scales of the Minnesota Multiphasic Personality Inventory (MMPI). Some studies imply that this profile allows one to conclude that such patients exaggerate their symptoms, have strong feelings of inadequacy, have emotional problems which are neurotic, with implications that this is functional pain. The present study and its results challenges the use of the MMPI in attempting to distinguish psychogenic from organic pain. The MMPI was administered to 62 patients on their admission to the hospital. All 62 patients had a diagnosis of some organic findings consistent with their pain symptomatology. The average MMPI scores resulted in an elevated "Conversion-V" profile. It was also noted that as characteristics such as age of the subject, number of surgeries, and number of physicians seen increased, there was a corresponding increase in the neurotic scales. It was concluded that utmost caution should be used in interpreting individual pain patients' MMPI scores. It is especially important to avoid dismissing the pain symptomatology as functional by simply giving the patient a psychiatric diagnosis consistent with the profile. The potential of the MMPI as an aid in developing the treatment plan and as a possible predictive tool for certain treatment procedures is discussed. It is suggested that MMPI data be collected on a comparison group of patients, who have had successful relief of pain through surgical intervention.