Pain catastrophizing, anxiety, and depression in hip pathology
Top Cited Papers
- 1 July 2019
- journal article
- research article
- Published by British Editorial Society of Bone & Joint Surgery in The Bone & Joint Journal
- Vol. 101-B (7), 800-807
- https://doi.org/10.1302/0301-620x.101b7.bjj-2018-1309.r1
Abstract
Aims Psychological factors play a critical role in patient presentation, satisfaction, and outcomes. Pain catastrophizing, anxiety, and depression are important to consider, as they are associated with poorer outcomes and are potentially modifiable. The aim of this study was to assess the level of pain catastrophizing, anxiety, and depression in patients with a range of hip pathology and to evaluate their relationship with patient-reported psychosocial and functional outcome measures. Patients and Methods Patients presenting to a tertiary-centre specialist hip clinic were prospectively evaluated for outcomes of pain catastrophizing, anxiety, and depression. Validated assessments were undertaken such as: the Pain Catastrophizing Scale (PCS), the Hospital Anxiety Depression Scale (HADS), and the 12-Item Short-Form Health Survey (SF-12). Patient characteristics and demographics were also recorded. Multiple linear regression modelling, with adaptive least absolute shrinkage and selection operator (LASSO) variable selection, was used for analysis. Results A total of 328 patients were identified for inclusion, with diagnoses of hip dysplasia (DDH; n = 50), femoroacetabular impingement (FAI; n = 55), lateral trochanteric pain syndrome (LTP; n = 23), hip osteoarthrosis (OA; n = 184), and avascular necrosis of the hip (AVN; n = 16) with a mean age of 31.0 years (14 to 65), 38.5 years (18 to 64), 63.7 years (20 to 78), 63.5 years (18 to 91), and 39.4 years (18 to 71), respectively. The percentage of patients with abnormal levels of pain catastrophizing, anxiety, or depression was: 22.0%, 16.0%, and 12.0% for DDH, respectively; 9.1%, 10.9%, and 7.3% for FAI, respectively; 13.0%, 4.3%, and 4.3% for LTP, respectively; 21.7%, 11.4%, and 14.1% for OA, respectively; and 25.0%, 43.8%, and 6.3% for AVN, respectively. HADS Anxiety (HADSA) and Hip Disability Osteoarthritis Outcome Score Activities of Daily Living subscale (HOOS ADL) predicted the PCS total (adjusted R2 = 0.4599). Age, HADS Depression (HADSD), and PCS total predicted HADSA (adjusted R2 = 0.4985). Age, HADSA, patient’s percentage of perceived function, PCS total, and HOOS Quality of Life subscale (HOOS QOL) predicted HADSD (adjusted R2 = 0.5802). Conclusion Patients with hip pathology may exhibit significant pain catastrophizing, anxiety, and depression. Identifying these factors and understanding the impact of psychosocial function could help improve patient treatment outcomes. Perioperative multidisciplinary assessment may be a beneficial part of comprehensive orthopaedic hip care. Cite this article: Bone Joint J 2019;101-B:800–807.Keywords
This publication has 58 references indexed in Scilit:
- Psychometric Properties of Patient-Reported Outcome Measures for Hip Arthroscopic SurgeryThe American Journal of Sports Medicine, 2013
- Pain Catastrophizing: An Updated ReviewIndian Journal of Psychological Medicine, 2012
- A Short Version of the International Hip Outcome Tool (iHOT-12) for Use in Routine Clinical PracticeArthroscopy: The Journal of Arthroscopic & Related Surgery, 2012
- Instruments to assess physical activity in patients with osteoarthritis of the hip or knee: a systematic review of measurement propertiesOsteoarthritis and Cartilage, 2011
- Long-term Cognitive Impairment and Functional Disability Among Survivors of Severe SepsisJAMA, 2010
- Outcome measures for orthopaedic interventions on the hipThe Journal of Bone and Joint Surgery. British volume, 2008
- Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classificationsInternational Orthopaedics, 2007
- Pain assessmentEuropean Spine Journal, 2005
- The Comorbidity of Major Depression and Anxiety DisordersThe Primary Care Companion For CNS Disorders, 2001
- The Hospital Anxiety and Depression ScaleActa Psychiatrica Scandinavica, 1983