Affective, anxiety, and substance-related disorders in patients undergoing herniated disc surgery

Zieger, Margrit; Luppa, Melanie; Matschinger, Herbert; Meisel, Hans Jörg; Günther, Lutz; Meixensberger, Jürgen; Toussaint, René; Angermeyer, Matthias C.; König, Hans‐Helmut; Riedel‐Heller, Steffi G.

doi:10.1007/s00127-010-0283-2

Cited by 9 publications

(6 citation statements)

References 37 publications

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“…Clinicians should be aware of the high prevalence rates of psychiatric comorbidity in back pain patients, in particular in the most severe cases which are treated via surgery. If applicable, they should consider the assessment of psychiatric distress and support of mental health professionals [ 39 ]. Multimodal diagnostic and therapy approaches that pay attention to psychiatric comorbidity may help to improve the outcomes of surgical therapy and to reduce the costs connected to psychiatric comorbidity.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric comorbidity as predictor of costs in back pain patients undergoing disc surgery: a longitudinal observational study

Konnopka

Löbner

Luppa

et al. 2012

BMC Musculoskelet Disord

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BackgroundPsychiatric comorbidity is common in back pain patients undergoing disc surgery and increases economic costs in many areas of health. The objective of this study was to analyse psychiatric comorbidity as predictor of direct and indirect costs in back pain patients undergoing disc surgery in a longitudinal study design.MethodsA sample of 531 back pain patients was interviewed after an initial disc surgery (T0), 3 months (T1) and 15 months (T2) using the Composite International Diagnostic Interview to assess psychiatric comorbidity and a modified version of the Client Sociodemographic and Service Receipt Inventory to assess resource utilization and lost productivity for a 3-month period prior interview. Health care utilization was monetarily valued by unit costs and productivity by labour costs. Costs were analysed using random coefficient models and bootstrap techniques.ResultsPsychiatric comorbidity was associated with significantly (p < 0.05) increased direct (+664 Euro) and indirect costs (+808 Euro) at T0. The direct cost difference predominantly resulted from medical health care utilization and was nearly unchanged at T2. Further important cost predictors were clinical variables like the presence of chronic medical disease, the number of previous disc surgeries, and time and gender.ConclusionPsychiatric comorbidity presents an important predictor of direct and indirect costs in back pain patients undergoing disc surgery, even if patients do not utilize mental health care. This effect seems to be stable over time. More attention should be given to psychiatric comorbidity and cost-effective treatments should be applied to treat psychiatric comorbidity in back pain patients undergoing disc surgery to reduce health care utilization and costs associated with psychiatric comorbidity.

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Section: Discussionmentioning

confidence: 99%

Psychiatric comorbidity as predictor of costs in back pain patients undergoing disc surgery: a longitudinal observational study

Konnopka

Löbner

Luppa

et al. 2012

BMC Musculoskelet Disord

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“…Despite the prevalence of psychiatric comorbidities in persons undergoing cervical disk surgery is much higher than in a general population, 10 psychological component of disability following cervical disk surgery is rarely addressed in scientific studies. The small randomized controlled study of Chuang et al justifies a low-quality evidence that interactive presurgical educational session more effectively reduces anxiety and uncertainty in perioperative period than an educational booklet in patients undergoing cervical disk surgery.…”

Section: Discussionmentioning

confidence: 99%

“…psychiatric comorbidities, rotator cuff syndrome) and their functional consequences. 4,7–12 Some patients after cervical disk surgery may be approached by a single professional (e.g. physiotherapist for abnormal posture, occupational therapist for ergonomic training, speech therapist for dysphagia or dysphonia, psychologist for ineffective coping or social worker to resume work).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of rehabilitation after cervical disk surgery: a systematic review of controlled studies

Tederko

Krasuski²,

Tarnacka

2018

Clin Rehabil

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Objectives: To present a synopsis of evidence on the efficacy of rehabilitation after cervical disk surgery performed for neck pain and radiculopathy. Data sources: The databases of Medline, EMBASE, and Cochrane Central were searched for studies reporting effects of rehabilitation interventions in patients undergoing surgery due to cervical disk disease with pain and radicular syndrome, published before 31 August 2018. Review methods: Project was registered with PROSPERO database (number CRD42018085937). Randomized controlled trials that evaluated the efficacy of rehabilitation interventions versus other, sham, or no treatment were selected. The primary outcomes were disability and pain. Secondary outcomes were other measures assessing biological, psychological or social effect of rehabilitation. Two reviewers independently screened studies for eligibility, assessed risk of bias and extracted data. Evaluation of evidence was performed with the GRADE system. Results: Five papers were included in the review. The eligible studies were heterogeneous in intervention and outcome reporting. There are low- to very-low-quality evidence that some interventions (use of cervical collars after non-plated anterior cervical diskectomy an fusion, structured physiotherapy, and interactive patients’ education) provide some benefit within functioning, pain, and selected psychological variables in patients undergoing cervical disk surgery. Controlled trials addressing comprehensive interdisciplinary rehabilitation, multidisciplinary pain management, occupational therapy, psychotherapy, social and vocational interventions were not identified. Conclusion: There is insufficient evidence with few trials of low quality to allow any conclusion to be drawn about the effectiveness, harms, and general ineffectiveness of rehabilitation for people who have had cervical disk surgery for pain or radiculopathy.

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“…There are several studies investigating psychological factors in relation to lumbar disc herniation surgery. Disc surgery patients show a higher risk of mental disorders than the general population (25). Screening for pre-surgical distress is likely to identify patients at risk for poor outcome after surgery (26).…”

Section: Discussionmentioning

confidence: 99%

Patientsâ€™ experience of health three years after structured physiotherapy or surgery for lumbar disc herniation

G¹,

G²,

Thomeé³

et al. 2013

J Rehabil Med

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Objective: To describe the experience of health among pa tients 3 years after treatment with a structured physiothera py model or surgery for lumbar disc herniation. Design: A qualitative research study. Subjects/patients: Patients were referred to the orthopaedic clinic at Sahlgrenska University Hospital with sciatica due to lumbar disc herniation. Twenty patients who were eligi ble for surgery were treated either with a structured physio therapy model or with surgery. Methods: Openended interviews were conducted and ana lysed using content analysis. Results: Findings were grouped into two themes: feeling of wellbeing and feeling of illbeing. In the group treated with structured physiotherapy there were a high number of codes in the feeling of wellbeing theme. In the group treated with surgery there were a high number of codes in the feeling of illbeing theme. Conclusion: Patients treated with structured physiotherapy or surgery experienced feelings of wellbeing and illbeing 3 years after treatment. Patients treated with physiotherapy and surgery described varying experiences of health 3 years after treatment for lumbar disc herniation. It can be specu lated that the experience of wellbeing may be explained by the ability of structured physiotherapy treatments to em power patients.

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Affective, anxiety, and substance-related disorders in patients undergoing herniated disc surgery

Abstract: Disc surgery patients show a higher risk to suffer from mental disorders than the general population. The assessment of psychiatric distress and the assistance by mental health professionals should be considered during hospital and rehabilitation treatment.

Cited by 9 publications

References 37 publications

Psychiatric comorbidity as predictor of costs in back pain patients undergoing disc surgery: a longitudinal observational study

Psychiatric comorbidity as predictor of costs in back pain patients undergoing disc surgery: a longitudinal observational study

Effectiveness of rehabilitation after cervical disk surgery: a systematic review of controlled studies

Patientsâ€™ experience of health three years after structured physiotherapy or surgery for lumbar disc herniation

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