The Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF) and Patient-Reported Outcomes Measurement Information System–29 (PROMIS-29) Comparison Study: Assessing for PROMIS-29 Depression and Anxiety Psychopathologic Cutoff Values Amongst Patients Undergoing Elective Complex Spine Procedures

Abstract

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) are used to assess patient psychology, pain, and quality of life. As psychological factors, such as depression and anxiety, are associated with poor perioperative outcomes, we aim to translate MMPI-2-RF values to PROMIS-29 scores and establish cutoff values for PROMIS-29 anxiety and depression domains that might warrant attention preoperatively. Seventy adult patients scheduled for an elective spinal surgery between July 2018 and February 2020 who completed both the MMPI-2-RF and PROMIS-29 preoperatively at a single institution were reviewed. Patients with MMPI-2-RF scores of 65 or greater (the cutoff for psychopathology) in the emotional/internalizing dysfunction scale (4.29%) had an average PROMIS-29 depression score of 14.33, which is significantly higher than the control group's (<65 score) 8.49 score (P= 0.04). Similarly, those demonstrating psychopathology on the demoralization (4.29%) and helplessness/hopelessness (4.29%) scales had average PROMIS-29 depression scores significantly higher than the control group's averages (15.33 vs. 8.45, P= 0.02 and 14.33 vs. 8.49, P= 0.04, respectively). Patients with an MMPI-2-RF score of 65 or greater on the emotional/internalizing dysfunction (4.29%), stress/worry (10.00%), and anxiety (7.14%) scales had average PROMIS-29 anxiety domain scores of 15, 15, and 15, respectively, which were significantly greater than that of the control group's scores (8.94, P= 0.04; 8.75, P= 0.004; and 8.55, P < 0.001, respectively). PROMIS-29 scores of 15 or greater on the depression and anxiety domains may have psychopathologies that warrant addressing, given their increased likelihood of having poor outcomes.