Prevalence of and Factors Associated With Major Depression in Patients With Upper Extremity Conditions

Oflazoglu, Kamilcan; Mellema, Jos J.; Menendez, Mariano E.; Mudgal, Chaitanya S.; Ring, David; Chen, Neal C.

doi:10.1016/j.jhsa.2015.11.019

Cited by 32 publications

(18 citation statements)

References 27 publications

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“…16,17 Ring and colleagues observed a significant correlation between DASH score and pain-related anxiety for patients presenting with carpal tunnel syndrome, de Quervain tendinitis, lateral elbow pain, and trigger finger, but not for patients evaluated six weeks after initiation of non-operative distal radius fracture care. 17 Furthermore, pain-related anxiety was not an independent predictor of DASH score in their study.…”

Section: Discussionmentioning

confidence: 99%

“…16 However, correlation between anxiety and patient disability or function was not evaluated. Vranceanu observed a significant correlation between pain-related anxiety (PASS) and pain levels at time of suture removal following minor hand surgery, but did not observe a correlation with disability (DASH) following univariate or multivariable analysis.…”

Section: Discussionmentioning

confidence: 99%

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Association of Physical Function, Anxiety, and Pain Interference in Nonshoulder Upper Extremity Patients Using the PROMIS Platform

Kazmers

Hung

Rane

et al. 2017

The Journal of Hand Surgery

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Purpose The relationship between psychosocial factors and self-reported physical function among hand and upper extremity patients is complex. The Patient-Reported Outcomes Measurement Information System (PROMIS) platform has attempted to create a variety of specifically-targeted metrics which can be administered using computer adaptive testing (CAT). Three metrics measuring self-reported physical function (herein referred to in combination as “functional” metrics) include the PROMIS Physical Function (PF) CAT, PROMIS Upper Extremity (UE) CAT, and the quick-Dash (qDASH). Two metrics assessing psychosocial factors include the PROMIS Anxiety and Pain Interference (PI) CATs (“non-functional” metrics). This study evaluates whether the functional metrics were correlated with non-functional metrics. Methods The five questionnaires were administered prospectively on a tablet computer to all consecutive adult patients presenting to outpatient hand and upper extremity (non-shoulder) clinic at a tertiary academic medical center from 1/1/2014 – 11/1/2014. For patients with multiple visits during the study period, only the first was included. Data were evaluated retrospectively to assess the relationship between functional and non-functional measures, with Pearson correlation coefficients to understand the relationship between continuous variables, and one-way ANOVAs to examine for differences in outcome measures across demographic groups. Multivariable linear regression analyses were performed to determine factors predicting functional disability. Results We included 1299 patients: mean age was 46.8 years, 53% were female, and 23% were unemployed or on disability. The PROMIS PF CAT, PROMIS UE CAT, and qDASH scores were all significantly correlated with PROMIS Anxiety CAT (Pearson correlation coefficients −0.46, −0.48, and 0.53, respectively) and PROMIS PI CAT (−0.60, −0.65, and 0.76, respectively) scores. Multivariable regression analyses demonstrated that increased PROMIS Anxiety and Pain Interference CAT scores each independently and adversely influenced PROMIS PF CAT, PROMIS UE CAT, and qDASH scores. Conclusions Increasing levels of patient anxiety and pain interference are independently associated with decreased patient-reported upper extremity function. Clinical Relevance Statement This study provides further support of the biopsychosocial model by highlighting that increased anxiety is associated with decreased self-reported function using the PROMIS platform.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of Physical Function, Anxiety, and Pain Interference in Nonshoulder Upper Extremity Patients Using the PROMIS Platform

Kazmers

Hung

Rane

et al. 2017

The Journal of Hand Surgery

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“…This observation was also noted by Hutton and Williams 20 and has gained traction as providers are using tools like Patient-Reported Outcomes Measurement Information System (PROMIS) and PHQ-9 to determine the effect of mood disorder and anxiety on orthopaedic illnesses in more recent years. 15,21 PROMIS is a validated instrument to briefly measure mental health symptoms including depression and anxiety during a clinic visit to allow orthopaedic surgeons to keep these symptoms in mind while providing patient care. 22 Our findings indicate that presence of LE and female sex were significantly associated with a history of either depression, anxiety, or both.…”

Section: Discussionmentioning

confidence: 99%

Depression and Anxiety among Patients with Atraumatic Lateral Epicondylitis and Ulnar-Sided Wrist Pain

et al. 2019

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Background Ulnar-sided wrist pain (UWP) and lateral epicondylitis (LE) are common disorders that can be difficult to treat. Depression and anxiety have been shown to modify patient symptoms, disability and pain. Questions/Purposes The purpose of our study was to quantify the prevalence of depression and anxiety among patients with LE or UWP. A secondary aim was to determine if these patients report higher levels of pain upon presentation and if they are more likely to require occupational therapy. Patients and Methods A retrospective chart review was conducted, and patients included those with LE or UWP, atraumatic in origin, ages 18 and over, and ongoing use of noninvasive treatment of LE or UWP. Results Our final analysis included 97 patients of which 57 had LE, 34 had UWP, and 6 had both. The prevalence of a mood disorder was 34.0%. Anxiety and/or depression was more prevalent in patients with LE compared to UWP. The most common medication was alprazolam. Pain scores averaged 1.2 points higher in subjects with a history of a mental health disorder. After adjusting for age and sex, there was no significant association between prevalence of depression and/or anxiety and utilization of physical or occupational therapy. Conclusions Patients with either LE, UWP or both along with depression and/or anxiety may be less likely to improve with traditional treatments. Future investigations are warranted focusing on the value of a multidisciplinary team consisting of a hand surgeon, behavioral therapist, or psychologist to optimize treatment response. Level of Evidence This is a Level IV, case series study.

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“…Twelve percent of 190 patients presenting to one of three academic hospital-based hand surgeons met criteria for major depression based on the PHQ-9 Patient Health Questionnaire 14 . Symptoms of anxiety and pain interference correlated with depression in this patient sample, but the prevalence of these psychological disorders was not defined.…”

Section: Introductionmentioning

confidence: 99%

Relative Prevalence of Anxiety and Depression in Patients With Upper Extremity Conditions

Beleckas

Wright

Prather

et al. 2018

The Journal of Hand Surgery

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Prevalence of and Factors Associated With Major Depression in Patients With Upper Extremity Conditions

Cited by 32 publications

References 27 publications

Association of Physical Function, Anxiety, and Pain Interference in Nonshoulder Upper Extremity Patients Using the PROMIS Platform

Association of Physical Function, Anxiety, and Pain Interference in Nonshoulder Upper Extremity Patients Using the PROMIS Platform

Depression and Anxiety among Patients with Atraumatic Lateral Epicondylitis and Ulnar-Sided Wrist Pain

Relative Prevalence of Anxiety and Depression in Patients With Upper Extremity Conditions

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