RT Journal
A1 Kang, James D.
T1 Commentary on an article by M.D. Daubs, MD, et al.: “Clinical Impression Versus Standardized Questionnaire: The Spinal Surgeon's Ability to Assess Psychological Distress”
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2010
FD December 15
VO 92
IS 18
SP e39 1
OP 2
DO 10.2106/JBJS.J.01347
UL http://dx.doi.org/10.2106/JBJS.J.01347
AB 
The authors of this interesting study should be congratulated on a well-designed and executed clinical study that raises questions regarding the assessment of emotional well-being in patients with spinal disorders. This study attempted to determine whether spinal surgeons and other nonoperative spine specialists were able to accurately assess psychological distress in patients with spinal problems. The authors asked 400 new patients who presented with spinal disorders to complete the Distress and Risk Assessment Method (DRAM) psychological distress questionnaire and then determined in a blinded fashion how accurate eight physicians were in assessing the patients' level of distress. In general, the physicians were better able to identify patients who had a relatively normal level of stress, but their ability to identify patients who were classified as having a high level of psychological distress was poor. Spinal surgeons seemingly were worse than the nonoperative physicians in their ability to identify patients in distress. The authors advocate that all spinal surgeons and specialists should utilize the DRAM to better identify patients in psychological distress in order to improve the clinical outcomes of those patients.