Abordaje multidisciplinar para la detección de la simulación en lumbalgia crónica

Abstract

A multidimensional study on the symptom exaggeration in chronic low back pain patients is presented. The main aim is to detect discriminant patterns of malingered pain-related disability in order to develop a detailed protocol to the assessment of suspected malingering in cases with false or grossly exaggerated physical or psychological symptoms motivated by external incentives. Overall sample (n=88) was divided in four groups: low back pain patients not involved in litigation (n=15), low back pain patients involved in litigation (n=23), analogue low back pain-instructed participants (n=20), and control group (n=30). Several medical and psychological tests were administered to participants, including: medical complementary tests, self-efficacy and life personal self-report scales, the Oswestry Disability Index, the Chronic Disability Index of Waddell, the SF-36 Health Survey, the Structured Inventory of Malingered Symptomatology (SIMS), and the Minnesota Multiphasic Personality Inventory � 2 � Restructured Form (MMPI-2-RF). Data on mean group differences and predictive accuracy of the instruments used are presented. A protocol for the detection of malingering based on the differential profile scores between low back pain non-litigants and litigants is also addressed.