Clin Orthop Surg.  2016 Jun;8(2):164-167. 10.4055/cios.2016.8.2.164.

Failure Rate of Spine Surgeons in Preoperative Clinical Screening of Severe Psychological Disorders

Affiliations
  • 1Orthopedics Department, Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. omidif@mums.ac.ir
  • 2Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
  • 3Psychiatric Department, Psychiatric and Behavioral Sciences Research Center, Ibn Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
  • 4Department of Nuclear Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

BACKGROUND
The surgeon's attention to the patient's underlying psychological state is essential to attaining desired outcomes. We aimed to investigate the prevalence and severity of psychological disorders in patients undergoing elective spine surgery.
METHODS
In this case-control study, associated psychological disorders were assessed using the Hospital Anxiety and Depression Scale (HADS) questionnaire at a single academic spine surgery center from August 2013 to June 2015. The case group consisted of 68 adult patients (mean age, 38.2 ± 9.6 years; male:female = 41:27) undergoing elective spine surgery and the control group included 69 healthy visitors of the orthopedic patients (mean age, 37.1 ± 6.9 years; male:female = 40:29) who voluntarily participated in the study. The 2 groups were compared for statistical analysis and a p-value < 5% was considered significance.
RESULTS
There was no statistically significant intergroup difference with regard to gender and age. The incidences of abnormal anxiety and depression were the same in the case group (14 patients, 20.6%). The values were 3 (4.3%) and 5 (7.2%), respectively, in the control group, showing statistically significant difference. Any association between the severity of depression and age or sex could not be identified.
CONCLUSIONS
In spite of spine surgeons' attempts to screen severe psychological disorders preoperatively, up to 21% of which cannot be diagnosed prior to elective spine surgery. Therefore, we believe the use of a questionnaire would be helpful in assessing patients' underlying psychological state before elective spine surgery.

Keyword

Anxiety; Depression; Surgery; Psychiatric status; Spine

MeSH Terms

Adult
Anxiety/*diagnosis
Case-Control Studies
Depression/*diagnosis
Female
Humans
Male
Middle Aged
Spine/*surgery
Surgeons/*statistics & numerical data
Surveys and Questionnaires

Reference

1. Abtahi AM, Brodke DS, Lawrence BD, Zhang C, Spiker WR. Association between patient-reported measures of psychological distress and patient satisfaction scores after spine surgery. J Bone Joint Surg Am. 2015; 97(10):824–828.
Article
2. Havakeshian S, Mannion AF. Negative beliefs and psychological disturbance in spine surgery patients: a cause or consequence of a poor treatment outcome? Eur Spine J. 2013; 22(12):2827–2835.
Article
3. Thorvaldsen P, Sorensen EB. Psychological vulnerability as a predictor for short-term outcome in lumbar spine surgery: a prospective study (Part II). Acta Neurochir (Wien). 1990; 102(1-2):58–61.
Article
4. Young AK, Young BK, Riley LH 3rd, Skolasky RL. Assessment of presurgical psychological screening in patients undergoing spine surgery: use and clinical impact. J Spinal Disord Tech. 2014; 27(2):76–79.
Article
5. Watson D, Naragon-Gainey K. Personality, emotions, and the emotional disorders. Clin Psychol Sci. 2014; 2(4):422–442.
Article
6. Farchione TJ, Fairholme CP, Ellard KK, et al. Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behav Ther. 2012; 43(3):666–678.
Article
7. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361–370.
Article
8. Consortium for Spinal Cord Medicine. Early acute management in adults with spinal cord injury: a clinical practice guideline for health-care professionals. J Spinal Cord Med. 2008; 31(4):403–479.
9. Chaichana KL, Mukherjee D, Adogwa O, Cheng JS, McGirt MJ. Correlation of preoperative depression and somatic perception scales with postoperative disability and quality of life after lumbar discectomy. J Neurosurg Spine. 2011; 14(2):261–267.
Article
10. Manning JS. Psychiatric screening. J Fam Pract. 1994; 38(3):223–224.
11. Hobby JL, Lutchman LN, Powell JM, Sharp DJ. The distress and risk assessment method (DRAM). J Bone Joint Surg Br. 2001; 83(1):19–21.
Article
12. Maratos EC, Trivedi R, Richards H, Seeley H, Laing RJ. Psychological distress does not compromise outcome in spinal surgery. Br J Neurosurg. 2012; 26(4):466–471.
Article
13. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J Psychosom Res. 2002; 52(2):69–77.
14. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health Qual Life Outcomes. 2003; 1:14.
15. Daubs MD, Patel AA, Willick SE, et al. Clinical impression versus standardized questionnaire: the spinal surgeon's ability to assess psychological distress. J Bone Joint Surg Am. 2010; 92(18):2878–2883.
Article
Full Text Links
  • CIOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr