Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2020

Open Access 01-12-2020 | Mood Disorders | Research article

Prevalence and association of anxiety and depression among orthopaedic trauma inpatients: a retrospective analysis of 1994 cases

Authors: Yun Yang, Ting-ting Tang, Mei-ru Chen, Mao-ying Xiang, Ling-li Li, Xiao-ling Hou

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2020

Login to get access

Abstract

Background

Patients with traumatic injuries are often accompanied by emotional disorders, which seriously impede functional gains. The objective of this study was to identify the prevalence and risk factors associated with underlying anxiety and depression in orthopaedic trauma patients.

Methods

From July 2015 to December 2017, all orthopaedic trauma patients were included in the retrospective study. Patients with conditions that might affect cognitive impairment were excluded from the study. Basic demographic data were collected. All patients were screened for emotional disorders on admission using a simple questionnaire called “Huaxi Emotional-Distress Index” (HEI). Bivariate analyses and logistic regression were used to identify the factors associated with a HEI score of > 8.

Results

One hundred and sixty-two patients (8.1%) had a HEI score of > 8. About 1.0% of enrolled patients had severe emotional disorders (HEI score ≥ 17). The reasons caused by emotional disorders in patients with orthopaedic trauma were a higher Injury Severity Score (ISS), a higher visual analogue score (VAS) and type of surgery. On logistic regression, marital status was a protective factor for emotional disorders, while VAS and ISS were the risk factors for emotional disorders.

Conclusions

Although a significantly low percentage of orthopaedic trauma patients in our setting have emotional disorders, traumatic orthopaedic surgeons still need to pay attention to the risk of emotional disorders and integrate effective screening tools into clinical practice to screen for these factors and stratify emotional disorders. Appropriate targeted psychological intervention and treatment should be adopted according to the stratification of emotional disorders.
Literature
1.
go back to reference Vincent HK, Hagen JE, Zdziarski-Horodyski LA, Patrick M, Sadasiva KK, Guenther R, et al. Patient-reported outcomes measurement information system outcome measures and mental health in orthopaedic trauma patients during early recovery. J Orthop Trauma. 2018;32(9):467–73.CrossRef Vincent HK, Hagen JE, Zdziarski-Horodyski LA, Patrick M, Sadasiva KK, Guenther R, et al. Patient-reported outcomes measurement information system outcome measures and mental health in orthopaedic trauma patients during early recovery. J Orthop Trauma. 2018;32(9):467–73.CrossRef
2.
go back to reference Weinberg DS, Narayanan AS, Boden KA, Breslin MA, Vallier HA. Psychiatric illness is common among patients with orthopaedic polytrauma and is linked with poor outcomes. J Bone Joint Surg Am. 2016;98:341–8.CrossRef Weinberg DS, Narayanan AS, Boden KA, Breslin MA, Vallier HA. Psychiatric illness is common among patients with orthopaedic polytrauma and is linked with poor outcomes. J Bone Joint Surg Am. 2016;98:341–8.CrossRef
3.
go back to reference McCrabb S, Baker AL, Balogh ZJ, Lott N, Palazzi K, Naylor J, et al. Comorbid tobacco and other substance use and symptoms of anxiety and depression among hospitalized orthopaedic trauma patients. BMC Psychiatry. 2019;19(28):1–9. McCrabb S, Baker AL, Balogh ZJ, Lott N, Palazzi K, Naylor J, et al. Comorbid tobacco and other substance use and symptoms of anxiety and depression among hospitalized orthopaedic trauma patients. BMC Psychiatry. 2019;19(28):1–9.
4.
go back to reference Kumar S, Verma V, Kushwaha U, Calvello Hynes EJ, Arya A, Agarwal A. Prevalence and association of depression in in-patient orthopaedic trauma patients: a single centre study in India. J Clin Orthop Trauma. 2020;11(Suppl 4):S573–7.CrossRef Kumar S, Verma V, Kushwaha U, Calvello Hynes EJ, Arya A, Agarwal A. Prevalence and association of depression in in-patient orthopaedic trauma patients: a single centre study in India. J Clin Orthop Trauma. 2020;11(Suppl 4):S573–7.CrossRef
5.
go back to reference Giannoudis PV, Harwood PJ, Kontakis G, Allami M, Macdonald D, Kay SP, et al. Long-term quality of life in trauma patients following the full spectrum of tibial injury (fasciotomy, closed fracture, grade IIIB/IIIC open fracture and amputation). Injury. 2009;40(2):213–9.CrossRef Giannoudis PV, Harwood PJ, Kontakis G, Allami M, Macdonald D, Kay SP, et al. Long-term quality of life in trauma patients following the full spectrum of tibial injury (fasciotomy, closed fracture, grade IIIB/IIIC open fracture and amputation). Injury. 2009;40(2):213–9.CrossRef
6.
go back to reference Becher S, Smith M, Ziran B. Orthopaedic trauma patients and depression: a prospective cohort. J Orthop Trauma. 2014;28(10):e242–6.CrossRef Becher S, Smith M, Ziran B. Orthopaedic trauma patients and depression: a prospective cohort. J Orthop Trauma. 2014;28(10):e242–6.CrossRef
7.
go back to reference Gobbi G, Atkin T, Zytynski T, Wang S, Askari S, Boruff J, et al. Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood: a systematic review and meta-analysis. JAMA Psychiatry. 2019;76(4):426–34.CrossRef Gobbi G, Atkin T, Zytynski T, Wang S, Askari S, Boruff J, et al. Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood: a systematic review and meta-analysis. JAMA Psychiatry. 2019;76(4):426–34.CrossRef
8.
go back to reference Gokce A, Bekler H, Karacaoglu E, Servet E, Gokay NS. Anxiety and trauma perception and quality of life in patients who have undergone replantation. J Reconstr Microsurg. 2011;27(8):475–80.CrossRef Gokce A, Bekler H, Karacaoglu E, Servet E, Gokay NS. Anxiety and trauma perception and quality of life in patients who have undergone replantation. J Reconstr Microsurg. 2011;27(8):475–80.CrossRef
9.
go back to reference Meijer DT, Gevers Deynoot BDJ, Stufkens SA, Sierevelt IN, Goslings JC, Kerkhoffs GMMJ, et al. What factors are associated with outcomes scores after surgical treatment of ankle fractures with a posterior malleolar fragment? Clin Orthop Relat Res. 2019;477(4):863–9.CrossRef Meijer DT, Gevers Deynoot BDJ, Stufkens SA, Sierevelt IN, Goslings JC, Kerkhoffs GMMJ, et al. What factors are associated with outcomes scores after surgical treatment of ankle fractures with a posterior malleolar fragment? Clin Orthop Relat Res. 2019;477(4):863–9.CrossRef
10.
go back to reference Crichlow RJ, Andres PL, Morrison SM, Haley SM, Vrahas MS. Depression in orthopaedic trauma patients-prevalence and severity. J Bone Joint Surg. 2006;88(9):1927–33.PubMed Crichlow RJ, Andres PL, Morrison SM, Haley SM, Vrahas MS. Depression in orthopaedic trauma patients-prevalence and severity. J Bone Joint Surg. 2006;88(9):1927–33.PubMed
11.
go back to reference Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. J Gen Intern Med. 2001;16:606–13.CrossRef Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. J Gen Intern Med. 2001;16:606–13.CrossRef
12.
go back to reference Spitzer RL, Kroenke K, Williams JW, Löwe B. A brief measure for assessing generalized anxiety disorder: the gad-7. Arch Intern Med. 2006;166:1092–7.CrossRef Spitzer RL, Kroenke K, Williams JW, Löwe B. A brief measure for assessing generalized anxiety disorder: the gad-7. Arch Intern Med. 2006;166:1092–7.CrossRef
13.
go back to reference Beck AT, Steer RA, Brown GK. Beck Depression Inventory-II. San Antonio: Psychological Corporation; 1996. Beck AT, Steer RA, Brown GK. Beck Depression Inventory-II. San Antonio: Psychological Corporation; 1996.
14.
go back to reference Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.CrossRef Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–70.CrossRef
15.
go back to reference Wang J, Guo WJ, Zhang L, Deng W, Wang HY, Yu JY, et al. The development and validation of Huaxi emotional-distress index (HEI): a Chinese questionnaire for screening depression and anxiety in non-psychiatric clinical settings. Compr Psychiatry. 2017;76:87–97.CrossRef Wang J, Guo WJ, Zhang L, Deng W, Wang HY, Yu JY, et al. The development and validation of Huaxi emotional-distress index (HEI): a Chinese questionnaire for screening depression and anxiety in non-psychiatric clinical settings. Compr Psychiatry. 2017;76:87–97.CrossRef
16.
go back to reference Dong ZQ, Ma J, Hao YN, Shen XL, Liu F, Gao Y, et al. The social psychological impact of the COVID-19 pandemic on medical staff in China: a cross-sectional study. Eur Psychiatry. 2020;63(1):e65.CrossRef Dong ZQ, Ma J, Hao YN, Shen XL, Liu F, Gao Y, et al. The social psychological impact of the COVID-19 pandemic on medical staff in China: a cross-sectional study. Eur Psychiatry. 2020;63(1):e65.CrossRef
17.
go back to reference Maselesele VM, Idemudia ES. The role of social support in the relationship between mental health and posttraumatic stress disorder amongst orthopaedic patients. Curationis. 2013;36(1):E1–7.CrossRef Maselesele VM, Idemudia ES. The role of social support in the relationship between mental health and posttraumatic stress disorder amongst orthopaedic patients. Curationis. 2013;36(1):E1–7.CrossRef
18.
go back to reference Hall MJ, DeFrances CJ, Williams SN, Golosinskiy A, Schwartzman A. National Hospital Discharge Survey: 2007 summary. Natl Health Stat Rep. 2010;29:1–24. Hall MJ, DeFrances CJ, Williams SN, Golosinskiy A, Schwartzman A. National Hospital Discharge Survey: 2007 summary. Natl Health Stat Rep. 2010;29:1–24.
19.
go back to reference Kaske S, Lefering R, Trentzsch H, Driessen A, Bouillon B, Maegele M, et al. Quality of life two years after severe trauma: a single-centre evaluation. Injury. 2014;45(Suppl 3):S100–5.CrossRef Kaske S, Lefering R, Trentzsch H, Driessen A, Bouillon B, Maegele M, et al. Quality of life two years after severe trauma: a single-centre evaluation. Injury. 2014;45(Suppl 3):S100–5.CrossRef
20.
go back to reference Wegener ST, Carroll EA, Gary JL, McKinley TO, OʼToole RV, Sietsema DL, et al. Trauma collaborative care intervention: effect on surgeon confidence in managing psychosocial complications after orthopaedic trauma. J Orthop Trauma. 2017;31(8):427–33.CrossRef Wegener ST, Carroll EA, Gary JL, McKinley TO, OʼToole RV, Sietsema DL, et al. Trauma collaborative care intervention: effect on surgeon confidence in managing psychosocial complications after orthopaedic trauma. J Orthop Trauma. 2017;31(8):427–33.CrossRef
21.
go back to reference Castillo RC, Wegener ST, Newell MZ, Carlini AR, Bradford AN, Heins SE, et al. Improving outcomes at level I trauma centers: an early evaluation of the Trauma Survivors Network. J Trauma Acute Care Surg. 2013;74(6):1534–40.CrossRef Castillo RC, Wegener ST, Newell MZ, Carlini AR, Bradford AN, Heins SE, et al. Improving outcomes at level I trauma centers: an early evaluation of the Trauma Survivors Network. J Trauma Acute Care Surg. 2013;74(6):1534–40.CrossRef
22.
go back to reference de Moraes VY, Jorge MR, Faloppa F, Belloti JC. Anxiety and depression in Brazilian orthopaedics inpatients: a cross sectional study with a clinical sample comparison. J Clin Psychol Med Settings. 2010;17(1):31–7.CrossRef de Moraes VY, Jorge MR, Faloppa F, Belloti JC. Anxiety and depression in Brazilian orthopaedics inpatients: a cross sectional study with a clinical sample comparison. J Clin Psychol Med Settings. 2010;17(1):31–7.CrossRef
23.
go back to reference McCarthy ML, MacKenzie EJ, Edwin D, Bosse MJ, Castillo RC, Starr A, LEAP study group. Psychological distress associated with severe lower-limb injury. J Bone Joint Surg Am. 2003;85(9):1689–97.CrossRef McCarthy ML, MacKenzie EJ, Edwin D, Bosse MJ, Castillo RC, Starr A, LEAP study group. Psychological distress associated with severe lower-limb injury. J Bone Joint Surg Am. 2003;85(9):1689–97.CrossRef
24.
go back to reference Beleckas CM, Wright M, Prather H, Chamberlain A, Guattery J, Calfee RP. Relative prevalence of anxiety and depression in patients with upper extremity conditions. J Hand Surg Am. 2018;43(6):571.e1–8.CrossRef Beleckas CM, Wright M, Prather H, Chamberlain A, Guattery J, Calfee RP. Relative prevalence of anxiety and depression in patients with upper extremity conditions. J Hand Surg Am. 2018;43(6):571.e1–8.CrossRef
25.
go back to reference Degen RM, MacDermid JC, Grewal R, Drosdowech DS, Faber KJ, Athwal GS. Prevalence of symptoms of depression, anxiety, and posttraumatic stress disorder in workers with upper extremity complaints. J Orthop Sports Phys Ther. 2016;46(7):590–5.CrossRef Degen RM, MacDermid JC, Grewal R, Drosdowech DS, Faber KJ, Athwal GS. Prevalence of symptoms of depression, anxiety, and posttraumatic stress disorder in workers with upper extremity complaints. J Orthop Sports Phys Ther. 2016;46(7):590–5.CrossRef
26.
go back to reference Zis P, Daskalaki A, Bountouni I, Sykioti P, Varrassi G, Paladini A. Depression and chronic pain in the elderly: links and management challenges. Clin Interv Aging. 2017;12:709–20.CrossRef Zis P, Daskalaki A, Bountouni I, Sykioti P, Varrassi G, Paladini A. Depression and chronic pain in the elderly: links and management challenges. Clin Interv Aging. 2017;12:709–20.CrossRef
27.
go back to reference Michaelides A, Zis P. Depression, anxiety and acute pain: links and management challenges. Postgrad Med. 2019;131(7):438–44.CrossRef Michaelides A, Zis P. Depression, anxiety and acute pain: links and management challenges. Postgrad Med. 2019;131(7):438–44.CrossRef
28.
go back to reference Husain N, Humail SM, Chaudhry IB, Rahman R, Robinson H, Creed F. Psychological distress among patients of an orthopaedic outpatient clinic: a study from a low-income country. Ann General Psychiatry. 2010;9:9.CrossRef Husain N, Humail SM, Chaudhry IB, Rahman R, Robinson H, Creed F. Psychological distress among patients of an orthopaedic outpatient clinic: a study from a low-income country. Ann General Psychiatry. 2010;9:9.CrossRef
Metadata
Title
Prevalence and association of anxiety and depression among orthopaedic trauma inpatients: a retrospective analysis of 1994 cases
Authors
Yun Yang
Ting-ting Tang
Mei-ru Chen
Mao-ying Xiang
Ling-li Li
Xiao-ling Hou
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2020
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-020-02132-4

Other articles of this Issue 1/2020

Journal of Orthopaedic Surgery and Research 1/2020 Go to the issue