MMPI Profile as an Outcome “Predictor” in the Treatment of Noncancer Pain Patients Utilizing Intraspinal Opioid Therapy

Objective. To evaluate changes in Minnesota Multiphasic Personality Inventory (MMPI) profiles pre‐ and post‐treatment involving intrathecal opioid therapy. Patients and Methods. This study reports on 30 patients that were evaluated pre‐ and post‐intraspinal opioid therapy. Treatment duration was slightly more than four years. Each patient experienced chronic non‐cancer pain deemed suitable for trialing and subsequent implantation of a drug administration system (DAS). On average the patients had experienced pain for 8.4 years and had a mean of 3.2 pain‐related surgeries. Results. The patients could be divided into “positive change group” and “negative change group” based upon pre‐ and post‐treatment MMPI profiles. Those patients in the negative change group had more “normal profiles” pretreatment. This group evidenced less reduction in pain and was found to be using slightly higher levels of intraspinal opioids. Conclusions. These results would suggest that the MMPI profile may not be a good “predictor” of long‐term outcome utilizing intraspinal opioid therapy. Indeed, patients with the more normal profile pretreatment did not fare as well as those with the more elevated profile. A positive change in MMPI profile from pre‐ to post‐treatment was associated with a higher level of pain reduction. Patient selection therefore should be based not on a single test such as the MMPI, but on consistency across multiple sources of information including physical examination, complaints of pain and disability, behavioral observations, and psychological testing.     

Premorbid personality characteristics in Alzheimer's disease: an exploratory case—control study

Linking data from a case–control study of Alzheimer's disease (AD) with data from a Minnesota Multiphasic Personality Inventory (MMPI) outpatient study, we identified 13 AD cases and 16 controls for case–control comparison. The mean time between personality testing and onset of AD (or corresponding age for controls) was 13 years in cases and 14 years in controls. AD cases, but not the controls, had scores significantly greater than the normative reference on MMPI scales measuring social introversion (p = 0.05) and pessimism (p = 0.01). When compared to controls, AD cases had significantly greater scores on the social introversion scale (p = 0.03). Despite the small sample size and some design limitations of this exploratory study, our findings may suggest that subjects who score higher on these personality scales have a greater risk for AD.     

Relationship between saliva level of 3-methoxy-4-hydroxyphenylglycol and mental health in the elderly general population

Aims: A large number of studies on the monoamine systems in Alzheimer's disease (AD) have found abnormalities of the noradrenergic system in the brain, but there has been no report concerning the relationship between noradrenergic activity and cognitive function in elderly living in a community. The aim of the present study was to explore the relationship between saliva level of 3‐methoxy‐4‐hydroxyphenylglycol (sMHPG) and mental health in this population. Methods: The study was to examine the relationship between sMHPG and performance on the Mini‐Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and Beck Depression Inventory (BDI) in 213 elderly people living in the local community. Results: sMHPG in female subjects was positively correlated with age (r = 0.24, P = 0.003) and negatively correlated with scores on the MMSE (r = ?0.26, P = 0.0016) and FAB (r = ?0.19, P = 0.024), even after controlling for the effect of age (MMSE r = ?0.20, P = 0.013). Notably, sMHPG was correlated with the pentagon drawing score (P = 0.0008) of MMSE. sMHPG was significantly correlated with BDI score in male subjects, but negatively correlated in female subjects. A gender difference was found in the relationship between the sMHPG and BDI score. Conclusion: The measurement of sMHPG may be a useful marker of mental health in elderly community‐dwelling subjects.