title: Presurgical psychological screening in back pain patients: a review.
abstract: OBJECTIVE
  The objective of this article is to provide a brief overview of the major psychosocial risk factors impacting recovery from spine surgery.
  
  
  RESULTS
  Numerous personality, cognitive, behavioral and historical factors affecting surgical recovery are reviewed. Among the most significant issues that have been found to have an adverse influence on outcome are Minnesota Multiphasic Personality Inventory scale elevations associated with pain sensitivity, depression, anger and anxiety. Maladaptive pain coping strategies, litigation, workers' compensation and reinforcement of pain behavior by the spouse also have been found to reduce spine surgery results. A number of other factors are reviewed, including pre-existing psychological problems, sexual and physical abuse, marital distress and substance abuse.
  
  
  CONCLUSIONS
  Presurgical psychological screening should be included in the medical diagnostic process of spine surgery candidates, especially when the major goal is pain reduction, or when the surgeon recognizes the existence of psychosocial risk factors. Suggestions for future directions in the development of presurgical psychological screening procedures are also given.
authors.affiliation: The WellBeing Group and University of Texas Southwestern Medical Center, Plano 75093, USA.
authors.forename: J
authors.initials: J
authors.lastname: Epker
authors.forename: A R
authors.initials: AR
authors.lastname: Block
mesh_terms: D001416:Back Pain / Q000523:psychology* / Q000601:surgery*; D001519:Behavior; D003071:Cognition; D004644:Emotions; D006801:Humans; D010551:Personality; D011379:Prognosis; D011584:Psychology; D016896:Treatment Outcome