title: The impact of depression and anxiety on self-assessed pain, disability, and quality of life in patients scheduled for rotator cuff repair.
abstract: BACKGROUND
  Psychological status may be an important predictor of outcome and patient satisfaction after treatment for rotator cuff disease. Few prior studies have considered these factors. The objective of the study was to investigate the prevalence of psychological distress and its effect on self-assessed pain, disability, and health-related quality of life in patients scheduled for rotator cuff repair.
  
  
  METHODS
  We assessed 107 consecutive patients preoperatively using the Hospital Anxiety and Depression Scale (HADS); visual analog scale pain score; American Shoulder and Elbow Surgeons (ASES) scale; Korean Shoulder Scale (KSS); and World Health Organization Quality of Life Scale, Abbreviated Version (WHOQOL-BREF). Preoperative demographic, clinical, and radiologic parameters were also evaluated.
  
  
  RESULTS
  Of the patients, 28 (26.2%) had depression and 25 (23.4%) had anxiety. The HADS depression score was positively correlated with the visual analog scale pain score (P = .048) and negatively correlated with the ASES, KSS, and WHOQOL-BREF scores (P = .005, P = .004, and P < .0001, respectively). The HADS anxiety score was negatively correlated with the ASES, KSS, and WHOQOL-BREF scores (P = .034, P = .037, and P < .0001, respectively). On multivariate analysis with a linear regression model, the HADS depression score was an independent predictor of ASES, KSS, and WHOQOL-BREF scores (P = .02, P = .005, and P = .001, respectively).
  
  
  CONCLUSIONS
  Depression and anxiety had a negative impact on self-assessed outcome measurements in patients scheduled for rotator cuff repair. Depression was a strong predictor of functional disability and health-related quality of life. Our results suggest that preoperative psychological status may influence postoperative outcome after rotator cuff repair and thus is an essential part of preoperative assessment.
authors.affiliation: Pain Research Center, Department of Orthopedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, South Korea. oscho5362@dsmc.or.kr
authors.forename: Chul-Hyun
authors.initials: CH
authors.lastname: Cho
authors.forename: Hyuk-Jun
authors.initials: HJ
authors.lastname: Seo
authors.forename: Ki-Cheor
authors.initials: KC
authors.lastname: Bae
authors.forename: Kyung-Jae
authors.initials: KJ
authors.lastname: Lee
authors.forename: Ilseon
authors.initials: I
authors.lastname: Hwang
authors.forename: Jon J P
authors.initials: JJ
authors.lastname: Warner
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012647:Self-Assessment; D013315:Stress, Psychological / Q000453:epidemiology*; D016896:Treatment Outcome
keywords: Level I; Prognosis Study; Prospective Cohort; Rotator cuff; anxiety; depression; functional disability; pain; psychological distress; quality of life