Mental Health Status Of Patients Research Articles

Mental Health in Bariatric Surgery: Selection, Access, and Outcomes.

Severe obesity has many psychiatric consequences that can be influenced by bariatric surgery. The goal of this article is to review these challenges, including the mental health status of patients with severe obesity, the evaluation of surgical candidates, and the early and late effects of the operations, and tooffer some recommendations to manage these challenges. The failure of the insurance-mandated preoperative psychosocial evaluation is also discussed.

Effects of Tai Chi training on the physical and mental health status in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.

BackgroundTai Chi is a systematic whole body movement developed in ancient China. It plays an increasingly important role in the field of pulmonary rehabilitation for patients with chronic obstructive pulmonary disease (COPD). Our review aimed to explore the impact of Tai Chi on the physical and mental health of patients with COPD.MethodsWe searched several English and Chinese databases and used the combination of subject words and free words to search for available literature from the establishment of the library until August 28, 2018. Two researchers screened studies and collected the data independently. The study inclusion criteria included: (I) patients diagnosed with COPD; (II) Tai Chi or Tai Chi Qigong as an intervention in addition to routine treatment; (III) routine treatment with or without exercises as control group. The primary outcomes were lung function, exercise capacity and health status; (IV) randomized controlled trials.ResultsSixteen articles were included from 2009 to 2018 (n=1,096). The average time duration of Tai Chi program was 53.4 minutes each session, 4.13 sessions a week for a total of 4.13 months. Comparing with control group, Tai Chi group improved some lung function (forced volume capacity: mean difference =0.12, 95% CI: 0.03–0.21), (forced expiratory volume in 1s: mean difference =0.15, 95% CI: 0.08–0.21), enhanced 6-minute walking distance score (mean difference =30.78, 95% CI: 15.15–46.42), decreased COPD Assessment Test score (mean difference =−5.00, 95% CI: −7.51 to −2.50), decreased St. George’s Respiratory Questionnaire score (mean difference =−8.66, 95% CI: −14.60 to −2.72), enhanced Chronic Respiratory Disease Questionnaire score (mean difference =2.16, 95% CI: 1.49–2.83), decreased Hospital Anxiety and Depression Scale score(anxiety: mean difference =−1.04, 95% CI: −1.58 to −0.51; depression: mean difference =−1.25, 95% CI: −1.77 to −0.73). Comparing with exercise group, Tai Chi group statistically enhanced 6-minute walking distance score (mean difference =7.77, 95% CI: 2.63–12.91).ConclusionsTai Chi may represent an appropriate alternative or complement to standard rehabilitation programs. However, whether Tai Chi is better than pulmonary rehabilitation exercise has not been determined.

Effect of circular dances on quality of life of intestinal ostomized persons: A randomized controlled trial

Background and objective: Circular dances have several benefits to the physical and mental health status of patients. few investigations analyze the effect of dances on the Quality of Life of intestinal ostomized patients. We assessed the effect of circular dances on quality of life of intestinal ostomized persons.Methods: This is a randomized controlled trial conducted with 73 individuals were randomly clustered in two major groups: I) Controls to which the standard practices were applied and II) Cases to which all the standard procedures were applied but added the practices of circular dance. The Quality of life (QoL) score were assessed by the validated questionnaire COH-QOL-OQ.Results: No significant differences between the domains’ average scores before the intervention. The correlation between the average scores has decreased on the experimental group after the intervention suggesting that the circular dances managed to improve QoL scores.Conclusions: Circular dance practices on ostomized individuals contributes to a better QoL and represents an improvement on nursing care quality. Furthermore, the permanent review of nursing practices contributes significantly to the integral health care and better nursing services delivery to the ostomized individuals. Findings confirm the efficacy of circular dances to improve de Quality of Life of intestinal ostomized persons.

EHealth-supported case management for patients with panic disorder or depression in primary care: Study protocol for a cRCT (PREMA)

BackgroundPanic disorder (PD), frequently occurring with agoraphobia (AG), and depression are common mental disorders in primary care and associated with considerable individual and societal costs. Early detection and effective treatment of depression and PD/AG are of major importance. Cognitive behavioural exposure exercises have been shown to be effective in reducing anxiety and depressive symptoms. Practice team-based case management can improve clinical outcomes for patients with chronic diseases in primary care. The present study aims at evaluating the effects and cost-effectiveness of a primary care team-based intervention using behavioural therapy elements and case management supported by eHealth components in patients with PD/AG or depression compared to treatment as usual.Methods/designThis is a two-arm cluster-randomized, controlled trial (cRCT). General practices represent the units of randomisation. General practitioners recruit adult patients with depression and PD ± AG according to the International Classification of Diseases, version 10 (ICD-10). In the intervention group, patients receive cognitive behaviour therapy-oriented psychoeducation and instructions to self-managed exposure exercises in four manual-based appointments with the general practitioner. A trained health care assistant from the practice team delivers case management and is continuously monitoring symptoms and treatment progress in ten protocol-based telephone contacts with patients. Practice teams and patients are supported by eHealth components. In the control group, patients receive usual care from general practitioners. Outcomes are measured at baseline (T0), at follow-up after 6 months (T1), and at follow-up after 12 months (T2). The primary outcome is the mental health status of patients as measured by the Mental Health Index (MHI-5). Effect sizes of 0.2 standard deviation (SD) are regarded as relevant. Assuming a drop-out rate of 20% of practices and patients each, we aim at recruiting 1844 patients in 148 primary care practices. This corresponds to 12.5 patients on average per primary care practice. Secondary outcomes include depression and anxiety-related clinical parameters and health-economic costs.DiscussionIf the intervention is more effective than treatment as usual, the three-component (cognitive behaviour therapy, case-management, eHealth) primary care-based intervention for patients suffering from PD/AG or depression could be a valuable low-threshold option that benefits patients and primary care practice teams.Trial registrationGerman clinical trials register, DRKS00016622. Registered on February 22nd, 2019.

Use of the SF-12 questionnaire to assess physical and mental health status in patients with psoriasis.

Health-related quality of life (HRQoL) in psoriasis patients is generally measured using disease- or dermatology-specific questionnaires. Our objective was to use the generic 12-item Short Form Health Survey (SF-12) instrument to measure the physical and mental impact of psoriasis and to compare scores with those already published for different diseases. An observational study was conducted among mild-to-severe psoriasis outpatients. Health status was assessed by the SF-12, which includes a physical (PCS) and a mental (MCS) scale. The 12-item General Health Questionnaire (GHQ-12) was used to assess the possible presence of depression or anxiety, and the Skindex-17 to measure dermatology-specific HRQoL. Statistical analyses were performed to estimate the association between physical and mental health status and demographic and clinical characteristics. The study population included 1592 patients. Psoriasis PCS scores were similar to the general population and to non-severe diseases such as allergies, dermatitis, or back pain, while MCS mean scores were very similar to that of depression, and lower than those of all the other chronic conditions. Poor physical health was associated with female sex, older age, lower educational level, joint involvement, ≥2 comorbidities, moderate to very severe clinical status, GHQ-12 score ≥4, and moderate to severe Skindex-17 psychosocial scores. Poor mental health was associated with younger age (<30years), GHQ≥4, and severe Skindex-17 psychosocial scores. In conclusion, a general health measure, such as the SF-12, appears to be able to capture, in psoriasis patients, the burden of the disease both from a physical and a mental point of view.

Impaired mental health status in patients with chronic kidney disease is associated with estimated glomerular filtration rate decline.

Deteriorated health-related quality of life (HRQOL) is associated with increased risk for death in both chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients; however, the impact of HRQOL on CKD progression is not well investigated. We aimed to evaluate the association between HRQOL and CKD progression in Japanese patients with CKD. One hundred and three outpatients who visited the department of nephrology at our hospital (mean estimated glomerular filtration rate (eGFR); 32.1 ± 11.2 mL/min per 1.73 m2 ) between April 2007 and March 2012 were enrolled in this study. The primary outcome was 30% decline of eGFR or ESRD. We assessed HRQOL of all participants at baseline, including the physical component summary (PCS), the mental component summary (MCS) and the role/social component summary (RCS), using SF-36. Based on the baseline score of PCS, MCS and RCS, we divided all subjects into two groups by median. We studied 66 men (64.1%) and 37 women aged 61.7 ± 10.0 years old. During approximately 2.5 years of follow-up period, 59 patients (57.3%) reached 30% eGFR decline or ESRD. Cox regression analyses demonstrated that lower MCS score was significantly associated with CKD progression (hazard ratio (HR) = 1.83, 95% CI = 1.04-3.21, P = 0.035), but that lower PCS score and RCS score were not (HR = 0.70, 95% CI = 0.39-1.25, P = 0.223; HR = 0.95, 95% CI = 0.54-1.67, P = 0.854, respectively). We found that impaired mental health was associated with CKD progression. The evaluation of the mental health should be performed in the patients with CKD.

Predictors of Health-Related Quality of Life for Mental Health Status in Patients After Carotid Endarterectomy

To evaluate the health-related quality of life (HRQoL) in patients with carotid stenosis and identify the predictive factors that affect the mental health status in patients after carotid endarterectomy (CEA). A retrospective study was conducted of all patients presenting with carotid stenosis treated with CEA. Clinical data and demographics were collected for logistic regression analysis. The Short-Form General Health Survey Questionnaire (SF-36) and minimum clinically important difference were used to evaluate the mental health status of patients after CEA. Between January 2015 and September 2017, a total of 224 patients were enrolled in this study. At baseline, mean SF-36 scores for physical component summary (PCS) (60.1 ± 26.3) and mental component summary (MCS) (59.9 ± 23.1) were significantly lower in patients with carotid disease than the urban population (P < 0.001). After CEA, the SF-36 scores for PCS (62.5 ± 21.7) and MCS (68.4 ± 18.7) were increased. However, only the improvement of MCS achieved minimum clinically important difference. After multiple logistic regression analysis, contralateral stenosis ≥50% (odds ratio [OR] 0.266, 95% confidence interval [CI] 0.141-0.517) and hoarseness (OR 0.160, 95% CI 0.040-0.644) had negative effects on MCS. Dizziness improvement had positive effects on MCS (OR 2.882, 95% CI 1.569-5.298). Contralateral stenosis, dizziness improvement, and hoarseness may be the predictive factors that affect the mental health status in patients after CEA.

抑郁症患者的中医体质与心理健康状况的关系

抑郁症患者的中医体质与心理健康状况的关系

Mental health status in patients with stable coronary heart disease combined with nonalcoholic fatty liver disease

Objective. To assess the mental health status of the patients with stable coronary heart disease (CHD) based on the presence and progression of nonalcoholic fatty liver disease (NAFLD).Material and methods. 300 patients with stable CHD were observed. Among them 160 patients without NAFLD (Group I) and 140 patients with NAFLD (Group II) were observed. Assessment of mental health status was conducted by the Ukrainian versions of Hospital Anxiety and Depression Scale (HADS) and health questionnaire PHQ-15.Results. Analysis of the results revealed clear patterns of modifications of the patient's mental health depending on the availability and duration of NAFLD. In the case of NAFLD the prevalence of depressive mental disorders was found. However, the most important manifestations as in percentage and clinical symptoms were observed in patients with nonalcoholic steatohepatitis (NASH). Moreover, the total assessment score of patient health increased due to progression of anxiety and depression manifestations.Conclusions. Under conditions of stable CHD and NAFLD comorbidity, the total proportion of mental disorders is 80-88% and is characterized by the predominance of depressive disorders, that are most pronounced in patients with NASH.

PLHIV are more likely to have mental distress: evidence from a comparison of a cross-section of HIV and diabetes patients at Tertiary Hospitals in Nigeria

ABSTRACTHIV is now regarded as a chronic disease because of the availability of treatment. However, it is not well known if there are differences (clinically and in magnitude) between the mental health status of PLHIV and people living with other chronic diseases. The aim of this study was to compare the mental health status of patients attending antiretroviral clinics to patients attending diabetes clinics at tertiary hospitals in Ogun State, Nigeria. A comparative hospital-based cross-sectional study of mental distress among 639 HIV-positive and 639 diabetic patients was carried out. Multivariate logistic regression analysis was used to control for confounders and to predict the probability of mental distress in PLHIV. The mean age of the participants was 44.87 (± 13.83) years and it had a range of 63 years (17 to 80). The prevalence of mental distress was higher among HIV-positive participants (46.79%) than diabetic participants (33.02%) (p < 0.0001). HIV-positive participants had greater odds of mental distress than diabetics (odds ratio = 1.78; 95% CI = 1.41–2.25). HIV-positivity, female sex, lower levels of education, being unemployed, poorer housing conditions and separated, widowed or divorced were associated with higher odds of mental distress (p < 0.05). Mental distress was predicted by HIV-positivity, occupation and current marital status. HIV infection and social inequalities are independent risk factors for mental distress. The odds of having mental distress is higher among PLHIV compared with diabetic patients. Addressing social inequalities might be the critical factor in the control of mental distress among PLHIV.Abbreviations: ART: Anti-retroviral therapy; CI: Confidence interval; YLD: Years Lived with Disability; GHQ: General Health Questionnaire; HIV/AIDS: Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome; LMIC: Low and middle-income countries; MH: Mantel-Haenszel; PLHIV: People living with HIV; ROC: Receiver operating characteristic

Depression in patients treated with haemodialysis: a cross-sectional study

BackgroundThe increasing incidence of end-stage renal disease in the Palestinian population and the effect of the disease on the psychological status of the patient underlie the importance of increasing knowledge about the mental health status of patients with end-stage renal disease. The aim of this study was to estimate the prevalence of depression in Palestinian patients treated with haemodialysis and its correlation with patients' clinical characteristics, health-related quality of life (HRQoL), and adherence to medications. MethodsIn this cross-sectional study, we collected a convenience sample from ten haemodialysis centres in the West Bank, occupied Palestinian territory, over 3 months in 2015. The Beck Depression Inventory-II scale (BDI-II) was used to assess depression, the EuroQol-5 Dimension scale was used to assess HRQoL, and the Morisky Medication Adherance-8 scale was used to assess compliance. We used SPSS version 16.0 for all statistical analyses. The study was approved by the Institutional Review Board at the An-Najah National University. Informed verbal consent was obtained from the participants before the start of the study. FindingsWe interviewed 286 patients who were treated with haemodialysis. The mean age was 52·0 years (SD 14·3), and 172 (60%) patients were men. The median number of years of dialysis was 2 years (IQR 1–4). 209 (73%) patients had depression. Most participants were non-compliant with their drug regimens and had low HRQoL. High depression scores were associated with old age (p<0·0001), female sex (p=0·036), low income (p=0·041), living in rural areas or in a camp (p=0·032), not doing regular exercise (p<0·0001), unemployment (p<0·0001), having multiple comorbidities (p<0·0001), and low adherence to medications (p=0·0075). We found an inverse correlation between depression and HRQoL (p<0·0001). InterpretationThis study is to our knowledge the first of its kind in the West Bank. The incidence of depression is higher than reported in other communities. Most patients treated with haemodialysis were moderately to severely depressed and had low HRQol. There is a need to provide for a patient's needs in term of psychologist interviews and pharmacological and non-pharmacological interventions. FundingNone.

Clinical investigation of mental health status of patients with gestational diabetes

Objective To understand the mental health status and psychological performance of patients with diabetes mellitus in clinical pregnancy and to analyze its related factors, to provide a theoretical basis for further improving the nursing measures of gestational diabetes. Methods A total of 100 pregnant women with gestational diabetes (GDM) and 100 healthy pregnant women were selected as the research objects.Questionnaire survey and evaluation were carried out by using the general information questionnaire, the State-Trait Anxiety Inventory (STAI), Self-Rating Depression Scale (SDS), Rosenberg Self-Esteem Scale (SES), and Oral Glucose Tolerance Test (OGTT). Results Pregnant women with gestational diabetes had more anxiety than healthy pregnant women (P<0.01). Worries about maternal and child health, control of diet difficulties, trouble with blood glucose monitoring, high cost of treatment and long treatment time were important factors that cause anxiety in GDM pregnant women.GDM patients had more depression than healthy pregnant women(P<0.01). And the level of depression was higher than that of healthy pregnant women(P<0.01). Depression in GDM was positively correlated with state anxiety and trait anxiety, and the difference was statistically significant(P<0.01). The score of self-esteem was negatively correlated with trait anxiety score(P<0.01), i. e. the higher the anxiety, the lower the self-esteem score. Conclusions There are different levels of anxiety and depression in gestational diabetes patients.There is no significant difference in self-esteem scores between gestational diabetes patients and healthy pregnant women.In nursing of gestational diabetes patients, it should strengthen psychological counseling and health education to alleviate anxiety and depression in GDM pregnant women and improve their quality of life. Key words: Gestational diabetes mellitus patients; Depression; Anxiety; Self-esteem

The importance of recording mental health history – a case report

Until recently, dentists were not trained in psychology and access to education in psychiatry and mental health remained limited within the dental curriculum. A major obstacle for integrating mental health initiatives into primary healthcare services is the lack of consensus on a definition of mental health. Currently, there is widespread use of the term ‘mental health’ as a euphemism for ‘mental illness’. Mental health can be defined as the absence of mental disease, or it can be defined as a state of being that also includes the biological, psychological or social factors which contribute to an individual's mental state and ability to function within the environment. This lack of consensus on the definition of mental health has implications for research, policy and practice. Mental health issues will impact significantly upon many aspects of patients' health, including: seeking care, presentation, compliance with treatment and providing additional complexities in delivering routine care. Significant issues can arise in relation to routine care but, as dental procedures become more complex in their delivery and maintenance, the impact of undiagnosed mental health issues are likely to increase in prevalence and impact not only on individual patients but also their treating clinicians. CPD/Clinical Relevance: This case report provides an account of a case where early identification of the patient's mental health status may have prevented significant post-treatment sequelae.

Mental health status and its influencing factors among patients with inflammatory bowel disease

Objective To explore the mental health status among patients with inflammatory bowel disease (IBD) and analyze its influencing factors so as to provide a reference for improving the quality of life among these patients. Methods A total of 160 outpatients and inpatients with IBD in the Department of Gastroenterology at Wuxi Second People's Hospital were selected by convenience sampling from June 2015 to February 2017. They were investigated with the self-designed general information questionnaire, symptom checklist (SCL-90) , social support scale (SSRS) , adaptation, partnership, growth, affection and resolve (APGAR) . Results The positive detection rate of mental health among patients with IBD was 25.6%. The total score of SCL-90 (144.81±46.01) was significantly higher than the national norm of 2006 (P<0.05) . Compared with the national norm of 2006, the scores of factors in somatization, depression, anxiety were higher with significant differences (P<0.05) . There were statistically significant differences in mental health levels among different ages, monthly income, duration and severity of disease, social support, family function and negative life events (P<0.05) . Multiple linear stepwise regression analysis showed that the major influencing factors of mental health among patients with IBD were the duration of disease, social support, family function and negative life events interpreting 28.1% of the total variance on mental health status among patients. Conclusions The mental health status among patients with IBD is poor. The duration of disease, social support, family function and negative life events are the major influencing factors of mental health status of patients. Nurses should carry out correspondingly mental nursing intervention in time to improve the quality of life of patients. Key words: Psychology; Inflammatory bowel disease; Influencing factors

The effects of Y-shaped conchal cartilage transplantation on the correction of nasal deformity secondary to cleft lip and its influence on mental health

Patients who undergo corrective surgery for cleft lip are known to be at risk for subsequently developing secondary nasal deformity. The aim of this study was to investigate the effects of Y-shaped conchal cartilage transplantation on the correction of nasal deformity secondary to cleft lip and its influence on mental health. Sixteen patients with nasal deformity secondary to cleft lip admitted to The First People's Hospital Xuzhou (Xuzhou, China) from February 2014 to February 2015 were selected for the study. Conchal cartilage was taken from the patients and made into a Y-shaped stent, which was then transplanted into the nasal columella. The surgical outcomes and patient satisfaction were evaluated and HADS was used to compare the preoperative and postoperative mental health. After the affected side of the nose was corrected, the nasal profiles of 12 patients were significantly improved, the height of nasal columella and nostril was significantly increased, the nasal base and breadth were significantly shorter than those before operation and the nose wing-nasal breadth index on the affected side was significantly increased compared to that before operation and the differences were statistically significant (P<0.05). The satisfaction of each index after the operation was more than 90%. The mental health of patients after operation was notably improved compared to before operation and the difference was statistically significant (P<0.05). After the correction of secondary nasal deformity to cleft lip through Y-shaped conchal cartilage transplantation, the shape of the nasal tip was stable without the recurrence of deformities or distortion on the donor site of the auricle. Y-shaped conchal cartilage transplantation is an ideal treatment method for the moderate and severe secondary nasal deformity to cleft lip and effective perioperative mental intervention can improve the patient's mental health status, an outcome that is worth popularizing in clinical applications.

Mental health status of patients of occupational disease diagnosis and its affected factors

目的： 了解职业病诊断患者的心理健康状况，探讨其主要影响因素。 方法： 于2015年11月至2016年4月，收集127例职业病诊断患者，采用12项一般健康问卷（GHQ-12）及自编相关因素问卷进行心理健康状况及影响因素调查。 结果： 职业病诊断患者GHQ-12平均得分为（6.74±3.98）分，心理障碍高危人群（总分≥4分者）占74.0%。客观病情较重、已婚、患病后收入减少、单位主观和客观支持评分低及家庭人均年收入低是职业病诊断患者自评心理障碍的危险因素（P<0.05）。logistic逐步回归分析结果显示，患病后工资档次比患病前降低是心理健康的危险因素（OR=7.411，95%CI：2.302~23.860）；患病所从事工种年限（现工龄）长是心理健康的危险因素（OR=1.149，95%CI：1.030~1.282）；单位主观支持评分高是心理健康的保护因素（OR=0.737，95%CI：0.596~0.911）。 结论： 职业病诊断患者心理健康状况问题较严重，应重点关注患病前后收入变化大、从事工种年限长的患者。.

Path analysis on the influencing factors of mental health status in patients with cervical spondylosis

Objective To explore the influencing factors of mental health status in patients with cervical spondylosis, and provide references and basis for clinical psychological diagnosis and mental intervention. Methods A total of 1 026 patients with cervical spondylosis were recruited and investigated by self-designed demographic information questionnaire, symptom checklist-90 (SCL-90) , simple coping modes questionnaire (SCMQ) , social support rating scale (SSRS) and life event scale (LES) . Path analysis was used to analyze the data. Results The mental health status of patients with cervical spondylosis was significantly higher than norm[ (1.51±0.56) vs (1.44±0.43) points; t=33.598, P<0.01]. Social support was the strongest predictor for mental health status of patients, and the path coefficient was 0.79. Positive coping style, negative coping style and social support were direct influencing factors, and the path coefficients were 0.57, -0.52 and 0.79. The positive life events, negative life events, family financial status and course of disease were indirect influencing factors, and the coefficients were 0.36, 0.62, 0.29 and -0.49. Conclusions The mental health status of patients is at a low level, and it is influenced by several factors and these factors are interactive. Key words: Cervical spondylosis; Mental health status; Path analysis; Influencing factor

The Relationship between Physical Activity Intensity and Mental Health Status in Patients with Breast Cancer.

The aim of this study was to investigate the correlation between physical activity (PA) level and mental health status in a population-based sample of Korean female patients with breast cancer. Our analysis included 76 patients with breast cancer and 44 healthy controls. The Korean versions of the International Physical Activity Questionnaire (IPAQ), Beck Depressive Inventory (BDI), State-Trait Anxiety Inventory-KY (STAI-KY), and Somatosensory Amplification Scale (SSAS), and Quality of Life (QOL) scale were assessed. The frequency of moderate PA level in breast cancer patients was significantly lower than that of healthy control subjects (t = −2.6; P = 0.011). In turn, the incidence of low PA level in breast cancer patients was significantly higher than that observed in healthy controls (t = 2.85; P = 0.005). A moderate PA level was inversely correlated with BDI score (r = −0.35; P = 0.008) and was positively correlated with QOL score (r = 0.38; P = 0.011). A low level of PA was inversely correlated with SSAS score (r = −0.39; P < 0.001). In healthy controls, a high level of PA was positively correlated with QOL score (r = 0.50; P = 0.043). Moderate PA level was inversely correlated with SSAS score (r = −0.59; P < 0.001). A low level of PA was also positively correlated with BDI score (r = 0.35; P = 0.008). A moderate or low intensity of PA was inversely correlated with depression and somatosensory amplification and was positively correlated with QOL in breast cancer patients. Finally, we suggest that progressively low-to-moderate levels of PA can be well adapted to positively impact several measures of mental health.

Impact of vitiligo on psychosocial and mental health status of patients

Impact of vitiligo on psychosocial and mental health status of patients

Influence of the mental health status on a new measure of objective functional impairment in lumbar degenerative disc disease

Background ContextThe Timed Up and Go (TUG) test has recently been proposed as a simple and standardized measure for objective functional impairment (OFI) in patients with lumbar degenerative disc disease (DDD). PurposeThe study aimed to explore the relationship between a patient's mental health status and both patient-reported outcome measures (PROMs) and TUG test results. Study Design/SettingThis is a prospective institutional review board-approved two-center study. Patient SampleThe sample was composed of 375 consecutive patients scheduled for lumbar spine surgery and a healthy cohort of 110 control subjects. Outcome MeasuresPatients and control subjects were assessed with the TUG test and a comprehensive panel of subjective PROMs of pain intensity (visual analog scale [VAS]), functional impairment (Roland-Morris Disability Index [RMDI]), Oswestry Disability Index [ODI]), as well as health-related quality of life (hrQoL; Euro-Qol [EQ]-5D). MethodsStandardized age- and sex-adjusted TUG test T-scores were calculated. The dependent variable was the short-form (SF)-12 mental component summary (MCS) quartiles, and the independent variables were the TUG T-scores and PROMs. Direct and adjusted analyses of covariance were performed to estimate the interaction between the SF-12 MCS quartiles and the independent variables. ResultsIn patients, there was a significant decrease in the subjective PROMs, notably the VAS back pain (p=.001) and VAS leg pain (p=.035), as well as significant increase in the RMDI (p<.001), ODI (p<.001), and the EQ-5D index (p<.001) with every increase in the quartile of the SF-12 MCS. There were no significant group differences of OFI as measured by the TUG T-scores across the SF-12 MCS quartiles (p=.462). In the healthy control group, a significant decrease in VAS leg pain (p=.028), RMDI (p=.013), and ODI (p<.001), as well as a significant increase in the EQ-5D index (p<.001), was seen across the SF-12 MCS quartiles, whereas TUG T-scores remained stable (p=.897). ConclusionsThere are significant influences of mental hrQoL on subjective measures of pain, functional impairment, and hrQoL that might lead to bias when evaluating patients with lumbar DDD who suffer from reduced mental hrQoL. The TUG test appears to be a stable instrument and especially helpful in the evaluation of patients with lumbar DDD and mental health problems.