Assessment of the Prevalence and Severity of Insomnia in a Chronic Disabling Occupational Spinal Disorder Population: An Underemphasized Symptom

Abstract

19-82 years) and the mean age for WC patients was 46.5 years (range: 29-70 years). OUTCOME MEASURES: Patients completed a presurgical screening evaluation, including an interview with a psychologist, completing psychological questionnaires, as well as the MMPI-2-RF before spine surgery. METHODS: Patient who were referred for presurgical psychosocial screening completed questions and a structured interview. Data from these evaluations were compared for WC vs. Non-WC patients to determine if there were identifiable differences between these groups. RESULTS: Educational level differed significantly in the two groups with college completed by 35.7% of Non-WC vs. 8.3% of WC patients. Only 1.6% of Non-WC patients did not graduate from high school vs. 13.9% of WC patients. Pre-operatively, WC patients displayed relatively elevated sensitivity to symptoms reflected by higher scores on gastrointestinal problems, head pain, as well as neurological and cognitive complaint scales. WC patients’ MMPI-2-RF profiles displayed a greater sense of inefficacy, more behavior-restricting fears, more aggression, and a higher level of aberrant experiences. WC patients also reflected a greater sense of entitlement and demoralization. WC patients were not more fearful, worried, or depressed than Non-WC patients. CONCLUSIONS: Psychological factors have been reported to be related to surgical outcome. Compromised surgical outcomes in WC patients may be related to personality/behavioral factors that are more prominent in this population. This study found that WC patients had a lower level of education and had different personality profiles with respect to emotion, self-image, pain sensitivity and reported more physical complaints compared with Non-WC patients. Further investigation is underway to determine to what extent these factors contribute to the differences in surgical outcome. FDA DEVICE/DRUG STATUS: This abstract does not discuss or include any applicable devices or drugs.