STUDY OF THE LEVEL OF ANXIETY, DEPRESSION AND HOPELESSNESS IN PATIENTS WITH ASEPTIC NECROSIS OF THE FEMORAL HEAD IN THE PREOPERATIVE STAGE

Shornikov A. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The presence of non-psychotic mental disorders (NPMD) in patients with hip disorders, including femoral head aseptic necrosis (FHAN) requiring arthroplasty, leads to patients deterioration due to more severe pain in the postoperative period, treatment outcomes and, ultimately, to reduce healthrelated quality of life. The aim of the study: to investigate the level of anxiety and depression in patients with FHAN in the preoperative stage and to determine their relationship with NPMD. Materials and methods. 137 people (45 men and 92 women) with FHAN with various syndromic variants of NPMD aged 27 to 77 years were examined. All patients, depending on the duration of FHAN were divided into 2 groups: the first group consisted of 55 people with a duration of up to 5 years, the second group consisted of 82 people with a duration of more than 5 years. After a clinical and psychopathological study, the Beck Anxiety Scale (BAI), the Beck Depression Scale (BDI-II), and the Beck Hopelessness Scale (BHS) were used to assess individual mental symptoms. The results of the study and their discussion. According to the results of BDI-II, 17 people (12.4%) did not have depression, 26 (19.0%) people had mild, 48 people (35.0%) – moderate and 46 (33.6%) patients – severe depression. Analysis of the results revealed significant differences in the level of BDI-II in the direction of increasing the manifestations of depression on the increase in the duration of FHAN more than 5 years. According to the results of BAI, mild anxiety was detected in 65 patients (47.5%), moderate – in 51 patients (37.2%), severe – in 21 people (15.3%). The analysis found that the level of anxiety increases in patients with only the leading anxiety syndromes with increasing duration of FHAN. Hopelessness (according to BHS) was absent in 85 respondents (62.0%) and was present in 52 people (38.0%). Conclusions. The mental state assessment in patients with FHAN in the preoperative period with anxiety and depression levels determination optimize the care of these patients, and ultimately improve the health related quality of life.

avascular necrosis, nonpsychotic mental disorders, neurotic disorders, depression, anxiety

1. Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, et al. The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys. Epidemiol Psichiatr Soc [Internet]. 2009 [cited 2021 Jul 30];18(1):23-33. Available from: https://www. ncbi.nlm. nih.gov/pmc/articles/PMC3039289/.
2. Hampton SN, Nakonezny PA, Richard HM, Wells JE. Pain catastrophizing, anxiety, and depression in hip pathology. Bone Joint J. 2019 Jul;101(7):800-7.
3. Tsuji T, Nakata K, Vietri J, Jaffe DH. The added burden of depression in patients with osteoarthritis in Japan. Clinicoecon Outcomes Res [Internet]. 2019 Jun 20 [cited 2021 Jul 30];11:411-21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590842/.
4. Abramkin AA, Lisitsyna TA, Veltishchev DY, Seravina OF, Kovalevskaya OB, Glukhova SI, et al. Depression and severity of articular destruction in patients with rheumatoid arthritis. Ter Arkh. 2020 Jun 5;92(5):22-32.
5. Zheng S, Tu L, Cicuttini F, Zhu Z, Han W, Antony B, et al. Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms. BMC Musculoskelet Disord [Internet]. 2021 Jan 7 [cited 2021 Jul 29];22:40. Available from: https://www.ncbi.nlm.nih.gov/ pmc/articles /PMC7791830/.
6. Wood TJ, Thornley P, Petruccelli D, Kabali C, Winemaker M, de Beer J. Preoperative Predictors of Pain Catastrophizing, Anxiety, and Depression in Patients Undergoing Total Joint Arthroplasty. J Arthroplasty. 2016 Dec;31(12):2750-6.
7. Wood TJ, Gazendam AM, Kabali CB, Hamilton Arthroplasty Group. Postoperative Outcomes Following Total Hipand Knee Arthroplasty in Patients with Pain Catastrophizing, Anxiety, or Depression. J Arthroplasty. 2021 Jun;36(6):1908-14.
8. Richard HM, Cerza SP, De La Rocha A, Podeszwa DA. Preoperative mental health status is a significant predictor of postoperative outcomes in adolescents treated with hip preservation surgery. J Child Orthop. 2020 Aug 1;14(4):259-65.
9. Stundner O, Kirksey M, Chiu YL, Mazumdar M, Poultsides L, Gerner P, et al. Demographics and perioperative outcome in patients with depression and anxiety undergoing total joint arthroplasty: a population-based study. Psychosomatics. 2013 Apr;54(2):149-57.
10. Mei XY, Gong YJ, Safir O, Gross A, Kuzyk P. Long-term outcomes of total hip arthroplasty in patients younger than 55 years: a systematic review of the contemporary literature. Can J Surg. 2019 Aug 1;62(4):249-58.
11. Chen SB, Hu H, Gao YS, He HY, Jin DX, Zhang CQ. Prevalence of clinical anxiety, clinical depression and associated risk factors in chinese young and middle-aged patients with osteonecrosis of the femoral head. PLoS One. 2015;10(3):e0120234.
12. Gudmundsson P, Nakonezny PA, Lin J, Owhonda R, Richard H, Wells J. Functional improvement in hip pathology is related to improvement in anxiety, depression, and pain catastrophizing: an intricate link between physical and mental well-being. BMC Musculoskelet Disord. 2021 Feb 3;22(1):133.
13. He D, Xue Y, Li Z, Tang Y, Ding H, Yang Z, et al. Effect of depression on femoral head avascular necrosis from femoral neck fracture in patients younger than 60 years. Orthopedics. 2014 Mar;37(3):244-251.
14. Okpara S, Nakonezny P, Wells J. Do psychological factors or radiographic severity play a role in the age of onset in symptomatic developmental dysplasia of hip and femoroacetabular impingement syndrome? BMC Musculoskelet Disord [Internet]. 2019 Sep 5 [cited 2021 Jul 30];20:412. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728945/.
15. Alabajos-Cea A, Herrero-Manley L, Suso-Martí L, Alonso-Pérez-Barquero J, Viosca-Herrero E. Are Psychosocial Factors Determinant in the Pain and Social Participation of Patients with Early Knee Osteoarthritis? A Cross-Sectional Study. Int J Environ Res Public Health. 2021 Apr 26;18(9):4575.
16. Sharma A, Kudesia P, Shi Q, Gandhi R. Anxiety and depression in patients with osteoarthritis: impact and management challenges. Open Access Rheumatol [Internet]. 2016 Oct 31 [cited 2021 Aug 2];8:103-13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC5098683/.
17. Duivenvoorden T, Vissers MM, Verhaar JAN, Busschbach JJV, Gosens T, Bloem RM, et al. Anxiety and depressive symptoms before and after total hip and knee arthroplasty: a prospective multicentre study. Osteoarthritis and Cartilage [Internet]. 2013 Dec [cited 2021 Aug 2];21(12):1834-40. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1063458413009400.
18. Greene ME, Rolfson O, Gordon M, Annerbrink K, Malchau H, Garellick G. Is the use of antidepressants associated with patient-reported outcomes following total hip replacement surgery? Acta Orthop. 2016 Oct;87(5):444-51.
19. Beck AT, Steer RA, Brown GK. BDI-II, Beck depression inventory: manual. 2nd ed. San Antonio, Tex.: Boston: Psychological Corp.; Harcourt Brace; 1996. 38 p.
20. Beck AT, Steer RA, Ball R, Ciervo CA, Kabat M. Use of the Beck Anxiety and Depression Inventories for Primary Care with Medical Outpatients. Assessment [Internet]. 1997 Sep 1 [cited 2021 Feb 22];4(3):211-9. Available from: https://doi.org/10.1177/107319119700400301.
21. Beck A, Steer R. Beck Hopelessness Scale. London: Harcourt; 1988. 29 p.

«Bulletin of problems biology and medicine» Issue 3 (161), 2021 year, 172-176 pages, index UDK 616.718.4-002.4-021.4-089.163:616.89-008.454-047.37

10.29254/2077-4214-2021-3-161-172-176