Masked Depression in Men With Low Back Pain

Fifty male patients with low back pain attending a Rheumatology Department completed the Middlesex Hospital Questionnaire before treatment. Scores on three sub-scales distinguished between patients with a good outcome and with a poor outcome. Comparing the scores of these two groups with those of a normal population suggests that there are distinct populations of patients with low back pain. Examination of individual questions revealed that the “poor response” group was characterized by a depressive syndrome described principally in somatic terms. In these patients depression was unrecognized; it is concluded that the low back pain can be seen as a depressive equivalent. The questionnaire demonstrated an ability to predict response to treatment; it is felt that it may play a part in the further investigation of patients not responding to conventional treatment.