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Psychological factors in the treatment of chronic low back pain. Follow-up study of a back school intervention
Julkunen J, Hurri H, Kankainen J
Psychotherapy and Psychosomatics 1988;50(4):173-181
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The aim of the study was to investigate the role of certain psychological factors (eg, neurotic features, alexithymia, and hostility) as intervening variables modifying the outcome of the back school intervention or correlating with spontaneous recovery. The results indicated that those patients who reacted favorably to the back school intervention could be described as emotionally well adjusted and controlled showing relatively good cognitive capacity with undisturbed reality testing. The poor responders in the treatment group were less capable cognitively and not so well balanced emotionally. Patients showing spontaneous recovery in the control group were characterized by a more lively and less controlled way of expressing emotions and affects. In contrast to these, patients who showed increasing disability during the 1-year follow-up were characterized by restricted expression of emotions and affects indicating alexithymia.

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