Influence of emotional status and quality of life in patients with cervical disc herniation on the accuracy of topical diagnosis

What factors negatively influence the accuracy of topical diagnosis of spinal nerve root lesion during neurological examination has not been solved until now.

Objective: to identify the nature of the relationship between the accuracy of topical diagnosis of spinal nerve lesion from neurological symptoms in patients with cervical disk herniation and the peculiarities of their emotional status and quality of life.

Patients and methods. Forty-eight patients with cervical disc herniation were examined. At first, the level of spinal nerve root lesion established during neurological examination was compared with the results of magnetic resonance imaging or computed tomography and surgical intervention. Thereafter, the importance of emotional factors in determining the accuracy of topical diagnosis is studied in these patients.

Results and discussion. If there was a divergence between preliminary neurological and final diagnoses, personality traits, such as hysteria, psy-chasthenia, alexithymia, and trait anxiety were most significant. The most substantial differences were found in the index of alexithymia. The accuracy of topical diagnosis was influenced not only by the psychological profile of patients with cervical disc herniation, but also by their qualty-of-life indicators. These are persons who are anxious and suspicious and are characterized by anxiety, fearfulness, indecision, and constant doubt. They use the symptoms of a somatic disease as a means to avoid responsibility. These patients solve all their problems, by escaping into disease, which causes social maladjustment.

Conclusion. The features of an individual's psychological profile as increased anxiety, hysteria, and psychasthenia reduce the accuracy of topical diagnosis of the lesion by 25.6%. Patients with cervical disk herniation, low quality-of-life indicators, and high scale scores for hypochondria, depression, psychasthenia, and trait anxiety need their emotional status to be corrected.

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