Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Oct 19, 2024; 14(10): 1506-1512
Published online Oct 19, 2024. doi: 10.5498/wjp.v14.i10.1506
Changes in postoperative depression and anxiety and their relationship with recovery from femoral head necrosis: A longitudinal study
Guo-Zheng Fang, Jie Lin, Lie-Hu Cao, Tong-Sheng Liu, Yu-Hong Ma, Lu Yang
Guo-Zheng Fang, Lie-Hu Cao, Tong-Sheng Liu, Yu-Hong Ma, Lu Yang, Department of Orthopedics, Shanghai Baoshan Luodian Hospital, Shanghai 201908, China
Jie Lin, Department of Orthopedics, Shanghai Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
Co-first authors: Guo-Zheng Fang and Jie Lin.
Author contributions: Fang GZ was the guarantor and designed the study; Fang GZ and Yang L participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Cao LH, Liu TS, Ma YH, and Lin J critically revised the article for important intellectual content; all authors participated in this study and jointly reviewed and edited the manuscript. Fang GZ and Lin J, as the first authors, made equal contributions to this work. After discussion among all the authors, Fang GZ and Lin J as the first authors for three main reasons. First, this study was conducted as a collaborative effort and it is reasonable to designate the author as a joint first author. The author accurately reflects on the distribution of responsibilities and burdens related to the time and effort required to complete the research and the final manuscript. Designating two co-first authors ensures effective communication and management of post-submission matters, thereby improving the quality and reliability of the paper. Second, the co-first authors of the research team possessed diverse professional knowledge and skills from different fields, and their appointments best reflected this diversity. It also promotes the most comprehensive and in-depth exploration of research topics, ultimately enriching the readers' understanding by providing various expert perspectives. Fang GZ and Lin J made substantial and equal contributions throughout the study. Choosing these researchers as first co-authors and acknowledging and respecting their equal contributions demonstrates the spirit of collaboration and teamwork. We believe that designating Fang GZ and Lin J as co-first authors is suitable for our manuscript, as it accurately reflects the collaborative spirit, equal contribution, and diversity of our team.
Supported by Baoshan District Key Specialized Class A, Clinical Medical Center for Integrated Traditional Chinese and Western Medicine Treatment of Neck, Shoulder, Lumbar and Leg Pain, No. BSZK-2023-Z07.
Institutional review board statement: This study was reviewed and approved by the Medical Ethics Committee of Luodian Hospital in Baoshan District, Shanghai, China.
Informed consent statement: Consent was obtained from the patients and their guardians, and an informed consent form was signed.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lu Yang, BMed, Attending Doctor, Department of Orthopedics, Shanghai Baoshan Luodian Hospital, No. 88 Yongshun Road, Luodian Town, Shanghai 201908, China. yl18601605776@126.com
Received: August 1, 2024
Revised: August 23, 2024
Accepted: August 26, 2024
Published online: October 19, 2024
Processing time: 77 Days and 0.3 Hours
Abstract
BACKGROUND

Femoral head necrosis (FHN) can significantly affect patients' psychological well-being and functional outcomes. However, the long-term relationship between postoperative depression, anxiety, and functional recovery in patients with FHN remains unclear.

AIM

To investigate the dynamic changes in postoperative depression and anxiety and their relationship with functional recovery in patients with FHN for 3 years.

METHODS

Ninety-three patients with FHN who underwent surgical treatment in March 2020 to 2023 were enrolled in this longitudinal study. Depression and anxiety status were assessed using the hospital anxiety and depression scale (HADS) at baseline, 6 months, 1, 2, and 3 years postoperatively. Functional recovery was evaluated using the Harris hip score (HHS). The dynamic changes in HADS and HHS were analyzed using repeated measures ANOVA; the relationship between depression/anxiety status and functional recovery was examined using Pearson’s correlation analysis.

RESULTS

The mean HADS-depression (HADS-D) and HADS-anxiety (HADS-A) scores significantly improved over time (P < 0.001). The prevalence of depression and anxiety decreased from 36.6% and 41.9% at baseline to 10.8% and 12.9%, respectively, at 3 years postoperatively. The mean HHS increased significantly from 52.3 ± 10.5 at baseline to 88.1 ± 7.2 at 3 years postoperatively (P < 0.001). Significant negative correlations were found between HADS-D/HADS-A scores and HHS at all time points (P < 0.05).

CONCLUSION

The severity of depression and anxiety negatively correlated with functional recovery, highlighting the importance of psychological interventions in the management of patients with FHN.

Keywords: Femoral head necrosis; Postoperative depression; Postoperative anxiety; Functional recovery; Longitudinal study; Psychological intervention

Core Tip: This study highlights the dynamic changes in postoperative depression and anxiety in patients with femoral head necrosis (FHN) for 3 years and their impact on functional recovery. The findings revealed significant improvements in depression and anxiety levels, with a marked decrease in their prevalence over time. Concurrently, functional recovery demonstrated a substantial postoperative increase. A negative correlation was observed between depression/anxiety scores and functional recovery, highlighting the critical role of psychological interventions in improving the overall management of patients with FHN. These results highlight the importance of addressing mental health and physical recovery in patients undergoing surgical treatment for FHN.