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J Am Acad Orthop Surg, Vol 16, No 2, February 2008, 107-112.
© 2008 the American Academy of Orthopaedic Surgeons
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Psychological Evaluation of the Spine Patient

Robert J. Gatchel, PhD, ABPP and Tom G. Mayer, MD

Dr. Gatchel is Professor and Chair, Department of Psychology, College of Science, University of Texas at Arlington, Arlington, TX. Dr. Mayer is Clinical Professor, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Gatchel and Dr. Mayer.

Reprint requests: Dr. Gatchel, Department of Psychology, College of Science, The University of Texas at Arlington, 313 Life Science Building, 501 South Nedderman Drive, Arlington, TX 76019-0528.

The biopsychosocial perspective focuses on the interaction among biologic, psychological, and medicolegal variables of patients coping with a persistent medical condition. It is considered the most comprehensive and heuristic approach to psychological evaluation in the spine patient. Assessment proceeds in three steps, from global indices of emotional distress to evaluation of more specific diagnoses of psychopathology. Step 1, the initial screening, uses psychometrically sound instruments to determine the level of patient distress. Step 2, the psychosocial interview, indicates whether additional psychological testing is needed. Step 3, the presurgical evaluation, assesses patients being considered for a surgical procedure. This stepwise assessment approach significantly aids in yielding evidence-based outcomes as well as in identifying the patient who may be most recalcitrant to treatment intervention.






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Copyright © 2008 by the American Academy of Orthopaedic Surgeons.