Abstract

ObjectiveTo investigate the prevalence of clinical anxiety and clinical depression in Chinese young and mid-aged patients with osteonecrosis of the femoral head (ONFH) and to analyze their potential risk factors.MethodsTwo hundred and sixteen Chinese patients with ONFH were consecutively enrolled in this cross-sectional study from January 2010 to December 2010. The Zung self-rating anxiety scale (SAS) and the Zung self-rating depression scale (SDS) were used to assess the prevalence of clinical anxiety and clinical depression. An additional questionnaire containing seventeen items of potential risk factors was completed by all patients. Binary logistic regression analysis was employed to reveal potential risk factors of anxiety and depression.ResultsThe prevalence of clinical anxiety and clinical depression was 20.4% and 21.8% in Chinese young and middle-aged patients with ONFH, respectively. Binary regression analysis showed that independent risk factors correlated with high incidence of clinical anxiety included involved femoral head (OR = 3.168, 95% CI: 1.496 - 6.708) and stages of ONFH (ORIV-V / II = 5.383, 95% CI: 1.664-17.416). Independent risk factors correlated with high incidence of depression included gender (OR = 2.853, 95% CI: 1.467-5.778), comorbid diseases (OR = 4.243, 95% CI: 1.940-9.278) and stages of the disease (OR IV-V/II = 16.963, 95% CI: 4.404-65.331).ConclusionsPatients with bilateral ONFH are inclined to have clinical anxiety, while female patients and patients with comorbid diseases might tend to get clinical depression. Advanced stages of ONFH are independent risk factors for both clinical anxiety and clinical depression.

Highlights

  • Osteonecrosis of the femoral head (ONFH) is a refractory disease that can lead to collapse of the articular cartilage and disabling osteoarthritis of the hip

  • Binary regression analysis showed that independent risk factors correlated with high incidence of clinical anxiety included involved femoral head (OR = 3.168, 95% CI: 1.496 - 6.708) and stages of ONFH (ORIV-V / II = 5.383, 95% CI: 1.664-17.416)

  • Independent risk factors correlated with high incidence of depression included gender (OR = 2.853, 95% CI: 1.467-5.778), comorbid diseases (OR = 4.243, 95% CI: 1.940-9.278) and stages of the disease (OR IV-V/II = 16.963, 95% CI: 4.404-65.331)

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Summary

Introduction

Osteonecrosis of the femoral head (ONFH) is a refractory disease that can lead to collapse of the articular cartilage and disabling osteoarthritis of the hip Despite of those asymptomatic ONFH, there is a high prevalence (59%) of cases who progressed to symptomatic phrases and whose femoral heads collapsed without treatment [1]. Epidemiologic studies showed an average prevalence was 28.91 per 100000 populations in Korea, and nearly 20,000 new cases were diagnosed annually in the United States [3,4], ONFH mainly affects young and middle-aged people at their ages of 20–50 years, characterized by nonspecific symptoms of groin pain and restricted motion of the hip. No studies reported the mental status in patients with ONFH, their clinical anxiety and clinical depression. The potential risk factors correlated with anxiety and depression were investigated thoroughly

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