The course of depression and anxiety in patients undergoing disc surgery: a longitudinal observational study.
OBJECTIVE
This study examines longitudinal depression and anxiety rates in disc surgery patients in comparison to the general population, the change and associated determinants of depression and anxiety over time.


METHODS
The longitudinal observational study refers to 305 consecutive disc surgery patients (age range: 18-55 years). Depression and anxiety was assessed with the Hospital Anxiety and Depression Scale. Random effects regression models for unbalanced panel data were used.


RESULTS
Depression and anxiety decreases significantly during nine months after surgery. Depression rates vary between 23.6% (T0), 9.6% (T1) and 13.1% (T2). Only at T0 the depression rate differs significantly from the general population. Anxiety rates range between 23.7% (T0), 10.9% (T1) and 11.1% (T2). Compared to the general population anxiety rates are significantly higher at all three assessment points. Risk factors for anxiety or depression at the time of the surgery are psychiatric comorbidity before surgery, higher age, female gender, lower educational level, lower physical health status and higher pain intensity. Regarding depression and anxiety in the course of time significant time interactions were found for the existence of other chronic diseases, higher pain intensity and vocational dissatisfaction.


CONCLUSIONS
Compared to the general population patients undergoing herniated disc surgery are often affected by depression and anxiety during hospital treatment and also in the course of time. Multimodal diagnostics regarding psychological well-being, pain and physical health status may help to identify this risk group. The assistance by mental health professionals during hospital and rehabilitation treatment may reduce poor postoperative outcome.
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. Margrit.Loebner@medizin.uni-leipzig.de
Margrit
M
Löbner
Melanie
M
Luppa
Herbert
H
Matschinger
Alexander
A
Konnopka
Hans Jörg
HJ
Meisel
Lutz
L
Günther
Jürgen
J
Meixensberger
Matthias C
MC
Angermeyer
Hans-Helmut
HH
König
Steffi G
SG
Riedel-Heller
D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000453:epidemiology / Q000523:psychology / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000523:psychology*; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D059035:Perioperative Period / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011603:Psychophysiology; D013997:Time Factors