Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jan 19, 2025; 15(1): 101373
Published online Jan 19, 2025. doi: 10.5498/wjp.v15.i1.101373
Correlation between anxiety, depression, and social stress in young patients with thoracolumbar spine fractures
Bo Wang, Da Shi, Yin-Di Sun, Bo Dong
Bo Wang, Da Shi, Joint Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi’an 710054, Shaanxi Province, China
Yin-Di Sun, Bo Dong, Pain Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi’an 710054, Shaanxi Province, China
Author contributions: Wang B and Dong B contributed to the data analysis; Shi D and Sun YD led the quality assessments; Wang B wrote the original draft; Wang B and Dong B revised the manuscript; all authors have agreed on the manuscript to be submitted, provided final approval of the version to be published, and agree to be responsible for all elements of the work.
Institutional review board statement: This study was approved by the Ethic Committee of Honghui Hospital, Xi'an Jiaotong University (Approval No. 202404101).
Informed consent statement: The requirement for patients' informed consent for this study was waived due to its retrospective nature.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
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: Bo Dong, MMed, Doctor, Pain Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Beilin District, Xi’an 710054, Shaanxi Province, China. dongbohl@163.com
Received: September 12, 2024
Revised: October 25, 2024
Accepted: November 21, 2024
Published online: January 19, 2025
Processing time: 97 Days and 0.8 Hours
Abstract
BACKGROUND

Traumatic injuries, such as falling, car accidents, and crushing mostly cause spinal fractures in young and middle-aged people, and > 50% of them are thoracolumbar fractures. This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues, which causes paralysis of the lower limbs if there is no timely rehabilitation treatment. Young patients with thoracolumbar fractures find it difficult to recover after the operation, and they are prone to depression, low self-esteem, and other negative emotions.

AIM

To investigate the association between anxiety, depression, and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes.

METHODS

This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital, Xi’an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023. The general data of the patients were assessed with the Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), life events scale, and social support rating scale (SSRS) to identify the correlation between anxiety, depression scores, and social stress and social support. The Japanese Orthopedic Association (JOA) was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation.

RESULTS

According to the scores of HAMD and HAMA in all patients, the prevalence of depression in patients was 39% (39/100), and the prevalence of anxiety was 49% (49/100). Patients were categorized into non-depression (n = 61) and depression (n = 39), non-anxiety (n = 51), and anxiety (n = 49) groups. Statistically significant differences in gender, occupation, Pittsburgh Sleep Quality Index (PSQI) score, and monthly family income were observed between the non-depression and depression groups (P < 0.05). A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups. Both depression (r = 0.207, P = 0.038) and anxiety scores (r = 0.473, P < 0.001) were significantly and positively correlated with negative life events. The difference in negative life event scores as well as SSRS total and item scores was statistically significant between patients in the non-depression and depression groups (P < 0.05). The difference between the non-anxiety and anxiety groups was statistically significant (P < 0.05) in the negative life event scores as well as the total SSRS scores. Additionally, JOA scores were significantly lower in both anxious and depressed patients.

CONCLUSION

Young patients with thoracolumbar fractures are prone to anxiety and depression. Patients’ anxiety and depression are closely associated with social pressure, which reduces the life pressure of young patients with thoracolumbar fractures, enhances social support, and improves the psychology of anxiety and depression., which affects patients’ recovery.

Keywords: Patients with thoracolumbar fractures; Anxiety; Depression; Social pressure; Social support

Core Tip: Thoracolumbar fracture is a type of continuous injury of the thoracolumbar bone caused by an external force, which easily damages the peripheral nerve tissue of the body and causes lower limb paralysis. This study adopts a comprehensive approach, evaluating the interplay between psychological states (anxiety and depression) and social factors (stress and support), which provides a nuanced understanding of patient recovery dynamics.