PECULIARITIES OF THE AFFECTIVE SPHERE OF PATIENTS SUFFERING CHRONIC BACK PAIN

Abstract

The article analyzes the affective sphere of patients with chronic back pain, examines the severity of their psychopathological symptoms (SCL-90R: somatisation, obsessive-compulsive disorders, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid symptoms, psychoticism, additional questions of mental distress) and their anxiety and depression (HADS). The sample included 78 patients with chronic back pain and 62 people without problems with their locomotor apparatus. There are data confirming existence at patients with chronic back pain of certain psychological-emotional problems associated with psychopathological symptoms, anxiety and depression. The performed analysis showed that these patients have mainly the clinically expressed level of anxiety and depression.   Among the variety of psychosomatic complaints, the most relevant ones, characteristic for the patients with chronic back pain, are: sleeping and awakening disorders, restless and anxious sleep, disturbed eating behaviour (bad appetite or overeating), feeling of hopelessness, constant anxiety, irritation, emotional instability, negative expectations regarding interpersonal interactions, the feeling of guilt about inability to perform family roles in full, inability to support financially their families because chronic or periodic pain, limited functional activity, restricted freedom of movement. By generalizing the obtained information, we have identified two leading psychopathological phenomena that determine the clinical picture of affective manifestations characteristic for the examined patients - anxiety-depressive (55.1% of the patients) and sensitization-hostile (44.9%). From the clinical and psychological point of view, the affective symptoms characteristic for the people with anxiety-depressive manifestations include constellation of symptoms of anxiety, phobic anxiety and depression, and that of the people with sensitively hostile manifestations includes symptoms of hostility and interpersonal sensitivity, and some elements of psychosis and paranoia. Regardless of the leading psychopathological radical, all patients have severe somatic manifestations that have formed a pathological background for development of anxiety-depressive or sensitive-hostile affective symptoms.