Depression and Anxiety Screening Identifies Patients That may Benefit From Treatment Regardless of Existing Diagnoses.
Depression and Anxiety Screening Identifies Patients That may Benefit From Treatment Regardless of Existing Diagnoses.
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DOI：
10.1016/j.artd.2022.01.032
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发表时间：
2022-06
影响因子：
--
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中科院分区：
文献类型：
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本研究调查了全膝关节置换术患者抑郁和焦虑症状筛查的效用，根据患者的心理健康诊断和相关的处方药物来检查活跃症状的差异。这项横断面研究分析了2018年6月至2018年12月期间在三级诊所计划进行全膝关节置换术的594名患者。患者完成患者报告结果测量信息系统（PROMIS）抑郁和焦虑计算机化适应性测试，量化临床活跃症状。从健康记录中提取心理健康诊断和相关药物。统计分析评估了平均PROMIS评分和抑郁和焦虑症状加重发生率的组间差异。多变量线性回归模型显示，未服药（β 7.1, P < .001）和服药（β 8.6, P < .001）的抑郁症患者均与PROMIS抑郁评分较高相关。类似的模型表明，被诊断为焦虑并服用抗焦虑药的患者（β 8.4; P < .001）与未被诊断的患者相比，PROMIS焦虑评分更高。86例（15%）患者经历了高度焦虑和/或抑郁症状。加重的抑郁症状在被诊断为抑郁症的患者中更为普遍（19%未服药，24%服用抗抑郁药，5%未确诊：P < 0.001）。焦虑症状加重在被诊断为焦虑症并服用抗焦虑药物的患者中最为普遍（25% vs 7%被诊断为无药物焦虑症，8%未确诊：P < 0.001）。七分之一的关节置换术患者报告抑郁和/或焦虑症状加重。尽管大多数接受抗抑郁药和抗焦虑药治疗的关节置换术患者症状得到控制，但这些患者出现活跃症状的风险仍在增加。
This study investigated the utility of depression and anxiety symptom screening in patients scheduled for total knee arthroplasty to examine differences in active symptoms according to patients’ mental health diagnoses and associated prescription medications. This cross-sectional study analyzed 594 patients scheduled for total knee arthroplasty at a tertiary practice between June 2018 and December 2018. Patients completed Patient-Reported Outcomes Measurements Information System (PROMIS) Depression and Anxiety Computerized Adaptive Tests in clinic quantifying active symptoms. Mental health diagnoses and associated medications were extracted from health records. Statistical analysis assessed between-group differences in mean PROMIS scores and the prevalence of heightened depressive and anxiety symptoms. Multivariable linear regression modeling demonstrated that being diagnosed with depression without medication (β 7.1; P < .001) and with medication (β 8.6; P < .001) were each associated with higher PROMIS Depression scores. Similar modeling demonstrated that patients diagnosed with anxiety and prescribed an anxiolytic (β 8.4; P < .001) were associated with higher PROMIS Anxiety scores than undiagnosed patients. Eighty-six (15%) patients experienced heightened anxiety and/or depressive symptoms. Heightened depressive symptoms were more prevalent among those diagnosed with depression (19% without medication, 24% with antidepressant vs 5% undiagnosed: P < .001). Heightened anxiety symptoms were most prevalent among those diagnosed with anxiety and on anxiolytic medication (25% vs 7% diagnosed with anxiety without medication, 8% undiagnosed: P < .001). One in seven arthroplasty patients screened reported heightened depressive and/or anxiety symptoms. Despite the majority of arthroplasty patients on antidepressants and anxiolytics having symptoms controlled, these patients remain at increased risk of heightened active symptoms.
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影响因子：
3.5
作者：
Ali, Abdulemir;Lindstrand, Anders;Flivik, Gunnar
通讯作者：
Flivik, Gunnar
影响因子：
3.5
作者：
Buller, Leonard T.;Best, Matthew J.;Barsoum, Wael K.
通讯作者：
Barsoum, Wael K.
影响因子：
1
作者：
Goebel, S.;Baumann, B.;Faller, H.
通讯作者：
Faller, H.
影响因子：
3
作者：
Kroenke, Kurt;Baye, Fitsum;Lourens, Spencer G.
通讯作者：
Lourens, Spencer G.
DOI：
10.2106/jbjs.k.00888
发表时间：
2012-06-20
期刊：
The Journal of bone and joint surgery. American volume
影响因子：
--
作者：
Ellis, Henry B;Howard, Krista J;Bucholz, Robert
通讯作者：
Bucholz, Robert