Correlation of psychological assessment using SCL-90-R scale with surgical outcome

Abstract

OBJECTIVE: To investigate the relationship between psychosomatic disorders and surgical outcome using the Symptom Check List-90-Revised (SCL-90-R) scale. METHOD: A cross-sectional study was performed to assess the impact of preoperative psychological factors on surgical outcome by using the Symptom Check List-90-Revised scale. Sixty-one patients were evaluated preoperatively with the Symptom Check List-90-Revised scale while they verbally reported their pain at postoperative 2, 4, 6 and 24 hours. Neurological and radiological assessments were carried out at the same time. RESULTS: Symptom Check List-90-Revised scores were under 90 in 10 patients (16.5%) and over 90 in 51 patients (83.5%). Preoperative scores seemed to be highly related to sex, age and type of pathology. There was a statistically significant negative correlation between the score and the benefit from surgery (Fisher's Exact Test, p=0.007). CONCLUSION: As psychosomatic disorders are prominent in all health conditions, patient selection including psychological assessment may be a critical factor in determining functional outcomes in surgery. Patients with psychosomatic personalities may obtain less benefit from surgical intervention although surgical techniques are appropriate and postoperative clinical and radiological findings are as expected. Based on this limited sample of 61 patients, the Symptom Check List-90-Revised seems to be a useful tool in identifying additional psychological factors that may be effective on surgical outcome.