title: Responsiveness of depression and its influence on surgical outcomes of lumbar degenerative diseases.
abstract: OBJECTIVE
  To demonstrate the responsiveness of depression after surgery for lumbar degenerative disease and to verify the impact of this condition on surgical outcomes.
  
  
  METHODS
  A prospective cohort study with 91 patients with lumbar degenerative diseases who were evaluated preoperatively, at 30 days and 1 year postoperatively.
  
  
  METHODS
  Evolution of depression between the follow-ups and its correlation with satisfaction.
  
  
  METHODS
  Depression was assessed with Beck Depression Inventory. According to depression responsiveness, patients were classified into four groups: NN = no depression; ND = normal during the preoperative period and depression within 1 year; DN = depression during the preoperative period and normal within 1 year; DD = depression during the preoperative period and within 1 year.
  
  
  RESULTS
  Prevalence of preoperative depression was 28.6% and 17.6% within 1 year postoperatively. Most patients (65.4%) with depression in the preoperative period recovered postoperatively. Poor preoperative HRQoL measures were associated with higher rates of responsiveness of depression during the follow-up. Patients with depression at the 1-year postoperative follow-up had a worse functional outcome. Patients who improved from depression had similar outcome to those without depression. Dissatisfaction within 1 year postoperatively was greater in patients who become depressed after surgery and remain depressed at 1-year follow-up (NN = 8.8%; ND = 42.9%; DN = 17.6%; DD = 44.4%; P = 0.012).
  
  
  CONCLUSIONS
  Most patients with depression in the preoperative recover within 1 year postoperatively. Responsiveness of depression is associated with surgical outcomes. The presence of depression after the surgical treatment, independent of when it starts, had a major negative impact on prognosis.
authors.affiliation: Department of Neurosurgery, University of Caxias do Sul, Rua General Arcy da Rocha Nóbrega, 401/602, Caxias do Sul, RS, CEP: 95040-290, Brazil, asdrubalmd@gmail.com.
authors.forename: Asdrubal
authors.initials: A
authors.lastname: Falavigna
authors.forename: Orlando
authors.initials: O
authors.lastname: Righesso
authors.forename: Alisson Roberto
authors.initials: AR
authors.lastname: Teles
authors.forename: Lucas Piccoli
authors.initials: LP
authors.lastname: Conzati
authors.forename: Julia Bertholdo
authors.initials: JB
authors.lastname: Bossardi
authors.forename: Pedro Guarise
authors.initials: PG
authors.lastname: da Silva
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Cheng
mesh_terms: D000328:Adult; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011184:Postoperative Period; D057234:Preoperative Period; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery*; D013168:Spondylolisthesis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome