Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery

Purpose This study was designed to evaluate predictive factors that influence pain, mental health symptoms and postoperative outcomes at six-months post-hip preservation surgery (HPS) in adolescent surgical candidates. Methods In total, 58 HPS candidates (39 female, 19 male; mean age 15.53 years (10 to 19)) were evaluated. Diagnoses included: acetabular dysplasia (34); idiopathic femoroacetabular impingement (15); Perthes disease (six); avascular necrosis (six); and slipped capital femoral epiphysis (six). All patients underwent periacetabular osteotomy (36), surgical hip dislocation (17) or arthroscopy (five). Patients completed the following: Numerical Pain Rating Scale (NPRS); Child Health Questionnaire-87 (CHQ-87); Pediatric Symptom Checklist-Youth (PSC-Y), preoperatively and six months postoperatively. A single psychologist assessed patients in clinics and one to two additional appointments. Results In all, 78% of patients reported one to three years of pain prior to HPS (modified Harris hip score). All pain scores (NPRS) significantly decreased at six months postoperatively. Preoperative mental health scores (CHQ-87) significantly predicted postoperative pain scores (F(1, 57) = 4.07; p < 0.048; R2 = 0.068). Mental health symptoms (PSC-Y) decreased significantly (p < 0.001). Patients who were seen by a psychologist two or more times reported better six-month postoperative outcomes than those seen once: usual pain (NPRS; p = 0.012); patient-reported physical function (CHQ-87; p = 0.029); and mental health (PSC-Y; p = 0.019). HPS patients seen ≥ 60 days prior to surgery showed marked improvements at six months compared with patients seen < 60 days prior to surgery. Conclusion HPS candidates evaluated preoperatively by psychology, as part of an integrated treatment approach, demonstrated statistically significant improvements in pain, health-related quality of life and mental health symptoms. Two+ visits, more than 60 days prior to surgery appears to be impactful. Preoperative pain and mental health symptoms were predictive of postoperative pain. Level of Evidence: II

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Fast Starters and Slow Starters After Hip Arthroscopy for Femoroacetabular Impingement: Correlation of Early Postoperative Pain and 2-Year Outcomes

The American Journal of Sports Medicine ◽

10.1177/0363546520952406 ◽

2020 ◽

Vol 48 (12) ◽

pp. 2903-2909

Author(s):

Thu Quynh Nguyen ◽

James M. Friedman ◽

Sergio E. Flores ◽

Alan L. Zhang

Keyword(s):

Postoperative Pain ◽

Femoroacetabular Impingement ◽

Hip Arthroscopy ◽

Harris Hip Score ◽

Physical Component Score ◽

Pain Level ◽

Component Score ◽

Pain Scores ◽

Patient Reported ◽

The Relationship

Background: Patients experience varying degrees of pain and symptoms during the early recovery period after hip arthroscopy for femoroacetabular impingement (FAI). Some “fast starters” report minimal discomfort and are eager to advance activities, while “slow starters” describe severe pain and limitations. The relationship between these early postoperative symptoms and 2-year outcomes after hip arthroscopy is unknown. Purpose: To analyze the relationship between early postoperative pain and 2-year patient-reported outcomes (PROs) after hip arthroscopy for FAI. Study Design: Cohort study; Level of evidence, 2. Methods: Patients without arthritis or dysplasia who were undergoing primary hip arthroscopy for FAI were prospectively enrolled and completed validated PROs. Scores for visual analog scale (VAS) for pain were collected preoperatively and at 1 week, 6 weeks, and 2 years postoperatively. Scores for the modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and 12-Item Short Form Health Survey (SF-12) were collected preoperatively and 2 years postoperatively. Paired t tests were used to evaluate PRO score changes, and correlation analyses were used to assess relationships between early postoperative pain and 2-year postoperative outcomes. Results: A total of 166 patients were included (55% female; mean ± SD age, 35.29 ± 9.6 years; mean body mass index, 25.07 ± 3.98 kg/m2). Patients demonstrated significant improvements in PRO scores (VAS, SF-12 Physical Component Score, mHHS, and all HOOS subscales) at 2 years after hip arthroscopy for FAI ( P < .001). There was a significant correlation between lower 1-week VAS pain level (fast starters) and lower 2-year VAS pain level ( R = 0.31; P < .001) as well as higher 2-year PRO scores (SF-12 Physical Component Score, mHHS, and all HOOS subscales: R = −0.21 to −0.3; P < .001). There was no correlation between 1-week VAS pain and 2-year SF-12 Mental Component Score ( P = .17). Preoperative VAS pain levels showed positive correlations with 1-week postoperative pain scores ( R = 0.39; P < .001) and negative correlations with 2-year patient outcomes ( R = −0.15 to −0.33, P < .01). There was no correlation between 6-week postoperative pain scores and 2-year PRO scores. Conclusion: Fast starters after hip arthroscopy for FAI experience sustained improvements in outcomes at 2 years after surgery. Patient pain levels before surgery may delineate potential fast starters and slow starters.

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Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes

Family Practice ◽

10.1093/fampra/cmv014 ◽

2015 ◽

Vol 32 (3) ◽

pp. 317-322 ◽

Cited By ~ 2

Author(s):

D. H. Sorkin ◽

J. Billimek ◽

K. J. August ◽

Q. Ngo-Metzger ◽

S. H. Kaplan ◽

...

Keyword(s):

Mental Health ◽

Symptom Burden ◽

Medication Regimen ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Patient Reported

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Long-Term Outcomes of Service Women Injured on Combat Deployment

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010039 ◽

2020 ◽

Vol 18 (1) ◽

pp. 39

Author(s):

Jessica R. Watrous ◽

Cameron T. McCabe ◽

Amber L. Dougherty ◽

Abigail M. Yablonsky ◽

Gretchen Jones ◽

...

Keyword(s):

Mental Health ◽

Alcohol Use ◽

Health Behaviors ◽

Behavioral Health ◽

Psychological Health ◽

Poor Sleep ◽

Physical And Mental Health ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Patient Reported

Sex- and gender-based health disparities are well established and may be of particular concern for service women. Given that injured service members are at high risk of adverse mental and behavioral health outcomes, it is important to address any such disparities in this group, especially in regard to patient-reported outcomes, as much of the existing research has focused on objective medical records. The current study addressed physical and mental health-related quality of life, mental health symptoms, and health behaviors (i.e., alcohol use, sleep, and physical activity) among a sample of service women injured on deployment. Results indicate that about half of injured service women screened positive for a mental health condition, and also evidenced risky health behaviors including problematic drinking, poor sleep, and physical inactivity. Many of the mental and behavioral health variables demonstrated statistically significant associations with each other, supporting the relationships between psychological health and behaviors. Results provide additional evidence for the importance of access to integrated and effective mental healthcare treatment for injured service women and the need for screening in healthcare settings that address the multiple factors (e.g., mental health symptoms, alcohol use, poor sleep) that may lead to poor outcomes.

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Correlates of Mental Health Symptoms Among US Adults During COVID-19, March–April 2020

Public Health Reports ◽

10.1177/0033354920970179 ◽

2020 ◽

Vol 136 (1) ◽

pp. 97-106

Author(s):

Meghan Reading Turchioe ◽

Lisa V. Grossman ◽

Annie C. Myers ◽

Jyotishman Pathak ◽

Ruth Masterson Creber

Keyword(s):

Mental Health ◽

Health Literacy ◽

Cognitive Function ◽

Generation X ◽

Millennial Generation ◽

Financial Resources ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Adequate Health Literacy ◽

Patient Reported

Objectives An understanding of mental health symptoms during the coronavirus disease 2019 (COVID-19) pandemic is critical to ensure that health policies adequately address the mental health needs of people in the United States. The objective of this study was to examine mental health symptoms among US adults in an early stage of the COVID-19 pandemic. Methods We conducted a cross-sectional study in late March 2020 with a national sample of 963 US adults using an online research platform. Participants self-reported state of residence, psychosocial characteristics, and levels of anxiety, depression, anger, cognitive function, and fatigue in the context of COVID-19 using validated patient-reported outcomes scales in the Patient-Reported Outcome Measurement Information System measures. We used analysis of variance and multivariate linear regression to evaluate correlates of mental health symptoms. Results Overall, participants reported high levels of anxiety (mean [SD], 57.2 [9.3]) and depression (mean [SD], 54.2 [9.5]). Levels of anger, anxiety, cognitive function, depression, and fatigue were significantly higher among the Millennial Generation and Generation X (vs Baby Boomers), those with not enough or enough (vs more than enough) financial resources, females vs males), those with self-reported disability (vs no self-reported disability), and those with inadequate (vs adequate) health literacy. In adjusted models, being in Generation X and the Millennial Generation (vs Baby Boomer), having not enough or enough vs more than enough) financial resources, and having inadequate (vs adequate) health literacy were most strongly correlated with worse mental health symptoms. Conclusions Results suggest that mental health symptoms during the early stages of the COVID-19 pandemic were prevalent nationally, regardless of state of residence and especially among young, psychosocially vulnerable groups.

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Predictors of persistent postoperative pain after surgery for idiopathic scoliosis

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.15.210090 ◽

2021 ◽

pp. 1-6

Author(s):

Anastasios Charalampidis ◽

Lina Rundberg ◽

Hans Möller ◽

Paul Gerdhem

Keyword(s):

Mental Health ◽

Back Pain ◽

Postoperative Pain ◽

Idiopathic Scoliosis ◽

Pain Group ◽

Level Of Evidence ◽

Pain Scores ◽

Patient Reported ◽

Persistent Postoperative Pain ◽

Eq Vas

Purpose: To identify factors contributing to persistent postoperative pain in patients treated surgically for idiopathic scoliosis. Methods: In total, 280 patients aged ten through 25 years at surgery, were identified in the Swedish Spine registry; all having preoperative and postoperative visual analogue scale (VAS) for back pain scores. The patients were divided into a high and low postoperative pain group based on the reported postoperative VAS for back pain scores (by using 45 mm on the 0 mm to 100 mm VAS scale as a cut-off). The patient-reported questionnaire included VAS for back pain, the 3-level version of EuroQol 5-dimensional (EQ-5D-3L) instrument, the EuroQol VAS (EQ-VAS) and the Scoliosis Research Society 22r instrument (SRS-22r). Predictors of postoperative back pain were searched in the preoperative data. Results: The 67 (24%) patients that reported high postoperative VAS back pain (> 45 mm) also reported lower postoperative EQ-5D-3L, EQ-VAS and SRS-22r than patients with low postoperative VAS back pain (all p < 0.001). Two preoperative variables were independently associated with postoperative pain; each millimetre increase in preoperative VAS back pain (on the 0 mm to 100 mm scale) was associated with a higher risk of being in the high postoperative back pain group (odds ratio (OR) 1.03; 95% confidence interval (CI) 1.02 to 1.05) and each 1 point decrease on the preoperative SRS-22r mental health (scale from 1 to 5) was associated with a higher risk of being in the high postoperative back pain group (OR 1.68; 95% CI 1.03 to 2.73). Conclusion: High preoperative back pain and low preoperative mental health are independent predictors of back pain after surgery for idiopathic scoliosis. Level of Evidence: III

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