A comparison of psychosocial functioning and personality in amputee and chronic pain populations

Abstract

Objective: To compare two populations with disabling conditions, amputation and chronic pain, in terms of psychosocial functioning and personality factors. We hypothesized that the degree of disability of amputees would resemble that of patients with chronic musculoskeletal pain. We also examined the prevalence of personality characteristics stereotypic of chronic pain in the two samples.

Design: Survey.

Setting: Outpatients at the pain and amputee clinics of a teaching hospital.

Patients: Ninety-four patients (47.7% of the number approached) were selected in consecutive samples taken from records and clinics.

Main outcome measures: Sickness Impact Profile (SIP) and the Millon Clinical Multiaxial Inventory (MCMI).

Results: The two groups did not differ on the SIP total score. Sixteen of 47 amputees reported significant pain, and this group showed higher levels of overall disability than did patients with chronic musculoskeletal pain (n = 47) and significantly greater disability than the 31 amputees reporting low levels of pain. Contrary to common perceptions of chronic pain patients, 25% showed no significant evidence of psychopathology. Only anxiety and dysthymia levels were clinically elevated in more than 50% of chronic pain patients.

Conclusions: Results are discussed in terms of the dual disability of amputees with chronic pain and of the hazards of attributing common characteristics to heterogenous patient groups.