Psychosocial Variables in Outpatients Receiving Intrathecal Baclofen or Pain-Pump Therapy

Numerous studies have demonstrated that patients suffering from chronic health conditions are at an increased risk for experiencing psychosocial distress and developing psychological difficulties. Spasticity, a chronic condition generally defined as an increase in muscle tone while at rest, is frequently observed in a variety of medical populations. Spasticity is not only painful, it can also significantly impair mobility, daily functioning, and quality of life. Intrathecal baclofen and pain pump therapy have been viable treatment options for those patients with severe spasticity who have not responded to less invasive treatments. Several small studies have examined quality of life and patient-reported efficacy for spasticity patients receiving implantable intrathecal baclofen (ITB) therapy. However, no research has examined what variables may play a role in quality of life outcomes for spasticity patients across and between the varied diagnostic populations treated with ITB or baclofen pain-pump therapy in a large sample. The proposed study examined several psychosocial variables (e.g. health-related quality of life [HRQOL], level of social functioning, self-reported levels of optimism/pessimism) and psychological variables (e.g. depressive and other psychiatric symptoms, as well as self-reported pain ratings) within a heterogeneous population of patients that receive ongoing care with intrathecal baclofen or baclofen pain-pump therapy. A sample of 125 adults, aged 19 - 82 years (M=49.06) who had been treated with ITB and other intrathecal pain medications, were assessed. Participants individually completed a packet of questionnaires measuring the primary study constructs. Analyses (One-way ANOVAs and t-tests) showed that the sample differed greatly from the normative population across measures of depression, quality of life, pain, and social functioning. Additionally, group differences were discovered between subgroups of spasticity patients. Multiple regression analyses showed that higher satisfaction with one's social roles, lower levels of feeling limited in one's roles by his/her emotional health, and higher rates of vitality were predictive of quality of life.