Nonpsychotic mental disorders in patients with aseptic necrosis of the femoral head (literature review)

Abstract

Recently it has been reported of significant progress in the providing of surgical care to patients with aseptic necrosis of the femoral head. Given the unity of mental and somatic factors, as well as data on the interaction of mental factors and other chronic diseases of the hip joint, there is a significant link between non-psychotic mental disorders and aseptic necrosis of the femoral head. The aim of this review was to present current data on psychiatric disorders in patients of this category. Prolonged stress exposure, in particular due to pain, with activation of the sympathoadrenal system on the one hand and maintaining a high level of anxiety due to neurotic mechanisms of psychological protection on the other hand can lead to joint damage due to reduced sympathetic nerve fibers. Available data for incidence of anxiety and depression in Chinese patients show that almost every fifth patient has clinically significant symptoms. The stage of the disease (the need for surgical treatment) and comorbid diseases significantly increase the risk of anxiety and depression. Considerable attention is paid to the patient’s alcohol consumption problems and the relationship between alcohol abuse and the occurrence of aseptic necrosis. The presence of restrictions in movements influent not only to the physical, but also to the mental components of the quality of life. Physical and mental discomfort, pain, low quality of life are factors that reduce the willingness to participate in preventive measures, which ultimately leads to the need for more radical surgical intervention. Evaluation by a mental health professional before hip surgery allows for better results in the delayed recovery period.