Prevalence of Clinical Depression Among Patients After Shoulder Stabilization: A Prospective Study
| Autor: | Matthew D. Pepe, Kevin B. Freedman, Bradford S. Tucker, Danielle Weekes, Richard E. Campbell, Nicholas J. Giunta, Fotios P. Tjoumakaris, Weilong J Shi |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Joint Instability Male medicine.medical_specialty 03 medical and health sciences Arthroscopy 0302 clinical medicine Postoperative Complications Interquartile range Internal medicine Shoulder function Prevalence Medicine Health Status Indicators Humans Orthopedics and Sports Medicine Prospective Studies Prospective cohort study Depression (differential diagnoses) Psychiatric Status Rating Scales 030222 orthopedics business.industry Depression Shoulder Joint 030229 sport sciences General Medicine Odds ratio Middle Aged Confidence interval Clinical trial Treatment Outcome Cohort Preoperative Period Surgery Female Self Report business Follow-Up Studies |
| Zdroj: | The Journal of bone and joint surgery. American volume. 101(18) |
| ISSN: | 1535-1386 |
| Popis: | BACKGROUND Depression is a potential risk factor for poor postoperative outcomes. This study aimed to identify the prevalence of clinical depression symptoms before and after shoulder stabilization, as well as the relationship between depression and functional outcomes. METHODS Patients undergoing arthroscopic primary glenohumeral stabilization for recurrent instability were eligible for enrollment. Participants completed the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) and the Western Ontario Shoulder Instability Index (WOSI) questionnaire preoperatively and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Patients with a preoperative QIDS-SR score of ≥6 were assigned to the clinical depression group. RESULTS Seventy-six patients were enrolled and were prospectively followed during this study. Thirty-nine patients were stratified into the clinical depression group. Preoperatively, the clinical depression cohort had worse WOSI scores than the cohort without clinical depression (mean difference, 8.3% [95% confidence interval (CI), 0.5% to 16.1%]; p = 0.04). Both the clinical depression cohort and the cohort without clinical depression displayed an improvement in WOSI scores at 1 year postoperatively (p < 0.01 for both cohorts). Both the clinical depression cohort and the cohort without clinical depression displayed an improvement in QIDS-SR scores at 1 year postoperatively (p < 0.01 for both cohorts). At 1 year postoperatively, the clinical depression cohort continued to have worse WOSI scores than the cohort without clinical depression (mean difference, 12.2% [95% CI, 5.9% to 18.5%]; p < 0.01) and worse QIDS-SR scores; the median QIDS-SR score was 5.0 points (interquartile range [IQR], 2.0 to 8.0 points) for the clinical depression group and 0.0 points (IQR, 0.0 to 3.0 points) for the group without clinical depression (p < 0.01). The postoperative prevalence of clinical depression (24%) was lower than the preoperative prevalence (51%) (p < 0.01). Increasing patient age was associated with preoperative depression symptoms (odds ratio, 3.1; p = 0.03). CONCLUSIONS Fifty-one percent of patients with shoulder instability reported depression symptoms before the surgical procedure. Surgical intervention improved shoulder function and depression symptoms over time; however, the clinical depression cohort had worse postoperative shoulder and depression outcomes. LEVEL OF EVIDENCE Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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