MMPI disability profile is associated with degree of opioid use in chronic work-related musculoskeletal disorders.
OBJECTIVE
To examine the relationship between level of opioid use and Minnesota Multiphasic Personality Inventory (MMPI) findings among chronic pain patients who were about to begin a functional restoration program.


METHODS
A prospective cohort study of patients with chronic disabling occupational musculoskeletal disorders. A total of 768 consecutive patients with valid MMPI were divided into 2 groups: 398 patients who reported no opioid use upon admission (No); and 370 patients who reported opioid use upon admission (Yes). Average daily opioid doses (in morphine equivalents) could be determined for 287 of 370 patients, who were further divided into 4 opioid subgroups: Low (>0 to 30 mg, n=148); Medium (>30 to 60 mg, n=57); High (>60 to 120 mg, n=47); and Very High (>120 mg, n=35).


RESULTS
Seventy-five percent of the patients who produced valid MMPI profiles could be classified into 1 of the 4 MMPI profiles. Of those patients who could be classified, approximately 7% showed a Normal profile, 15% showed a Conversion V, 9% showed a Neurotic Triad, and 69% showed the Disability Profile. Although the Disability Profile accounted for the majority of patients in all opioid subgroups, the proportions did increase with pretreatment opioid dose, as expected, indicating a relationship between degree of psychopathology and level of pretreatment opioid use. Patients who did not take pretreatment opioids showed the highest proportions of Conversion V and Normal profiles, which indicate a lesser degree or absence of psychopathology, respectively. Patients who took pretreatment opioids were more than one-and-a-half times as likely as patients who did not take pretreatment opioids to produce the Disability Profile, whereas patients taking very high doses of pretreatment opioids were nearly 3 times as likely to produce this profile as patients who took no pretreatment opioids.


CONCLUSIONS
The results of this study support the hypothesis that increasing levels of pretreatment opioid use is associated with less desirable MMPI profiles, specifically the Disability Profile and, thus, greater levels of pretreatment psychopathology.
Kidner
Cindy L
CL
PRIDE Research Foundation, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Gatchel
Robert J
RJ
Mayer
Tom G
TG
D000328:Adult; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D002908:Chronic Disease; D015331:Cohort Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008950:MMPI; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D009784:Occupational Diseases / Q000150:complications / Q000523:psychology*; D010146:Pain / Q000188:drug therapy / Q000209:etiology*; D010147:Pain Measurement / Q000379:methods; D011584:Psychology; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D000700:Analgesics; D000701:Analgesics, Opioid