title: Psychological distress, personality traits and functional disability in patients with osteonecrosis of the femoral head.
abstract: BACKGROUND
  The aim of the present study was to investigate personality traits, psychological distress and functional disability in patients with non-traumatic osteonecrosis of the femoral head (ONFH).
  
  
  METHODS
  Sixty-seven patients participated in the study, 48 males and 19 females. The mean age was 37.6 years (SD: 10.92, range: 15 - 61). Seventy-five healthy individuals, age and sex matched, served as controls. Socio-demographic information and clinical data were collected. The following instruments were used: the General Health Questionnaire (GHQ-28), the Defence Style Questionnaire (DSQ) and the World Health Organization Disability Assessment Schedule II (WHO-DAS II).
  
  
  RESULTS
  Patients suffering from ONFH presented higher scores at the GHQ-28 compared to healthy controls (P < 0.001). Duration of disease (P < 0.047) and age (P < 0.023) were the main factors associated with psychological distress (P < 0.003). Personality traits such as image distorting (P < 0.025) and self-sacrificing (P < 0.029) were identified in patients with ONFH compared to healthy controls. Functional disability was associated with high scores at GHQ-28 scale (P < 0.001). The "adaptive personality structure", as measured by DSQ was negatively associated with functional impairment (P < 0.022).
  
  
  CONCLUSIONS
  Patients with ONFH more commonly present symptoms of psychological distress associated with distinct functional clinical parameters. The present study also reveals the role of personality traits. Further investigation could specify the possible influence of psychopathology and personality traits or coping strategies on the course of disease.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, School of Health Science, University of Thessaly, Greece.
authors.forename: Odysseas D
authors.initials: OD
authors.lastname: Mouzas
authors.affiliation: Department of Orthopaedics, Faculty of Medicine, School of Health Science, University of Thessaly, Greece.
authors.forename: Aristidis H
authors.initials: AH
authors.lastname: Zibis
authors.affiliation: Department of Psychiatry, Faculty of Medicine, School of Health Science, University of Thessaly, Greece.
authors.forename: Konstantinos S
authors.initials: KS
authors.lastname: Bonotis
authors.affiliation: Department of Psychiatry, Faculty of Medicine, School of Health Science, University of Thessaly, Greece.
authors.forename: Crysanthos D
authors.initials: CD
authors.lastname: Katsimagklis
authors.affiliation: Department of Neurology, Faculty of Medicine, School of Health Science, University of Thessaly, Greece.
authors.forename: George M
authors.initials: GM
authors.lastname: Hadjigeorgiou
authors.affiliation: Department of Psychiatry, Faculty of Medicine, School of Health Science, University of Thessaly, Greece.
authors.forename: Maria N
authors.initials: MN
authors.lastname: Papaliaga
authors.affiliation: Department of Orthopaedics, Faculty of Medicine, School of Health Science, University of Thessaly, Greece.
authors.forename: Apostolos P
authors.initials: AP
authors.lastname: Dimitroulias
authors.affiliation: Department of Orthopaedics, Faculty of Medicine, School of Health Science, University of Thessaly, Greece.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Malizos
keywords: Functional disability; Osteonecrosis; Personality traits; Psychological distress
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