Improved Orthopedic Health Does Not Necessarily Mean Improved Mental Health

Pain from a back, shoulder, or hip injury can make a person feel depressed, anxious, or even depressed. Many people in health care may assume that trauma heals, and so does mental health. But a new study by scientists at Washington University School of Medicine in St. Petersburg. Lewis notes that in the long term, symptoms of depression and anxiety often do not improve when an orthopedic patient's physical pain improves.

The researchers examined de-identified medical chart records of more than 11,000 patients treated at the University of Washington Orthopedic Clinic over nearly seven years. They found that anxiety symptoms improved only when patients had significant improvements in physical activity, but significant improvements in physical activity were not associated with significant increases in depression. The research was published in the JAMA Network Open Journal.

Said senior researcher Abby L. Cheng, MD, assistant professor of orthopedics. "The answer is mostly no."

Every orthopedic patient treated at the University of Washington Clinic is given a tablet during the exam that contains a series of questions about whether orthopedic problems are interfering with their lives. The inventory includes questions such as: "In the past 7 days, how much did the pain interfere with your ability to do housework?" and "In the past seven days, how much pain prevented you from sleeping?" He asked questions about each person's mental health.

"Our goal is to treat the individual and not just fix the hip joint or the knee joint, and physical problems related to mood, anxiety and even depression," Cheng said. "Patients suffer a lot, and it's hard to provide quality care without looking at the big picture."

Analyzing the questionnaire responses, Cheng's team found that over a period of about seven years, people with orthopedic problems did not improve their mental health because their physical symptoms did not improve.

"Some studies have shown that when you treat patients specifically for musculoskeletal problems, maybe screen them before and after hip replacement surgery, some mental health symptoms will also improve, at least in the short term," Cheng explains.

"But we haven't seen this improvement for years. Six months after surgery, the patient may be less anxious, but five years later, it may be a completely different story. However, these anxiety symptoms often return. Anxiety and the patient's hip or other Not with orthopedic problems."

Cheng said he was somewhat surprised by the results because it is a common belief in orthopedics that as physical health improves, so does mental health. But he says he often sees people in his practice with improved physical health but not dramatic improvements in mental health.

"What's interesting to me is that in cases where the patient's physical health has improved significantly, the patient's anxiety is somewhat reduced, but in many such cases the depression is not improved," he said.

"As physicians, we really care about how patients feel. A patient may be happy because they can now walk a mile, which is great. But another patient who can walk a mile may be unhappy because he can no longer walk. " Run a marathon and it's not good. Patients' perception of their well-being is most important, and it does not necessarily improve because pain decreases and physical function improves."

Additional information: Wei Zhang et al, Associations between Improvement in Physical Function, Pain Disorders and Mental Health in Musculoskeletal Patients, JAMA Network Open (2023). Preprint: DOI: 10.1101/2023.02.12.23285824

Citation : Good Bone Health Doesn't Always Mean Good Mental Health (2023, June 29), Retrieved June 29, 2023, from https://medicalxpress.com/news/2023-06--

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