TY - JOUR
T1 - Effects of Depression, Anxiety, and Pain Catastrophizing on Total Hip Arthroplasty Patient Activity Level
AU - Reine, Seth
AU - Xi, Yin
AU - Archer, Holden
AU - Chhabra, Avnessh
AU - Huo, Michael
AU - Wells, Joel
N1 - Publisher Copyright:
© 2022
PY - 2023/6
Y1 - 2023/6
N2 - Background: Improvements in psychological factors are strongly associated with increased physical activity in the general population. The effects of depression, anxiety, and pain catastrophizing on activity level have not been thoroughly explored in patients undergoing total hip arthroplasty (THA). Mental health markedly influences patient perspectives on treatment success and quality of life. We hypothesized that improvements in screenings for depression, anxiety, and catastrophizing correlate with improvements in activity levels after THA. Methods: Two hundred ninety two patients (313 hips) who underwent THA with a minimum 1-year (mean 615 ± 270 days) follow-up completed preoperative and postoperative surveys containing the University of California Los Angeles (UCLA) Activity Score, Hospital Anxiety Depression Scale (HADS), Pain Catastrophizing Scale (PCS), and Depression Anxiety Stress Scale-21 (DASS). Wilcoxon signed-rank tests were performed between preoperative and postoperative times for outcome measures. Partial Spearman's rank-order correlations were performed between the change in UCLA Score and the change in HADS, PCS, and DASS. Results: There were significant improvements in UCLA Score (P value < .0001) and every subscale of PCS, HADS, and DASS (P values < .0001). Significant negative correlations existed between change in UCLA Score and change in HADS-anxiety (rs = −0.21, P value < .001), change in HADS-depression (rs = −0.23, P value < .001), and change in DASS-anxiety (rs = −0.22, P value = .004) following THA. Weaker significant negative correlations existed between change in UCLA Score and change in the remaining PCS (P values = .006) and DASS-depression(P value = .037) subscales. Conclusion: Improvements in patient-reported depression, anxiety, and pain catastrophizing screenings following THA were associated with increased activity levels. Patients who were screened for catastrophizing, depression, and anxiety achieved statistically and clinically meaningful improvements in symptoms following THA. Addressing patient mental health provides another avenue for holistic care of THA patients.
AB - Background: Improvements in psychological factors are strongly associated with increased physical activity in the general population. The effects of depression, anxiety, and pain catastrophizing on activity level have not been thoroughly explored in patients undergoing total hip arthroplasty (THA). Mental health markedly influences patient perspectives on treatment success and quality of life. We hypothesized that improvements in screenings for depression, anxiety, and catastrophizing correlate with improvements in activity levels after THA. Methods: Two hundred ninety two patients (313 hips) who underwent THA with a minimum 1-year (mean 615 ± 270 days) follow-up completed preoperative and postoperative surveys containing the University of California Los Angeles (UCLA) Activity Score, Hospital Anxiety Depression Scale (HADS), Pain Catastrophizing Scale (PCS), and Depression Anxiety Stress Scale-21 (DASS). Wilcoxon signed-rank tests were performed between preoperative and postoperative times for outcome measures. Partial Spearman's rank-order correlations were performed between the change in UCLA Score and the change in HADS, PCS, and DASS. Results: There were significant improvements in UCLA Score (P value < .0001) and every subscale of PCS, HADS, and DASS (P values < .0001). Significant negative correlations existed between change in UCLA Score and change in HADS-anxiety (rs = −0.21, P value < .001), change in HADS-depression (rs = −0.23, P value < .001), and change in DASS-anxiety (rs = −0.22, P value = .004) following THA. Weaker significant negative correlations existed between change in UCLA Score and change in the remaining PCS (P values = .006) and DASS-depression(P value = .037) subscales. Conclusion: Improvements in patient-reported depression, anxiety, and pain catastrophizing screenings following THA were associated with increased activity levels. Patients who were screened for catastrophizing, depression, and anxiety achieved statistically and clinically meaningful improvements in symptoms following THA. Addressing patient mental health provides another avenue for holistic care of THA patients.
KW - THA
KW - activity level
KW - anxiety
KW - catastrophizing
KW - depression
KW - hip
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U2 - 10.1016/j.arth.2022.12.026
DO - 10.1016/j.arth.2022.12.026
M3 - Article
C2 - 36529194
AN - SCOPUS:85148763652
SN - 0883-5403
VL - 38
SP - 1110
EP - 1114
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 6
ER -