title: Failure Rate of Spine Surgeons in Preoperative Clinical Screening of Severe Psychological Disorders.
abstract: BACKGROUND
  The surgeon's attention to the patient's underlying psychological state is essential to attaining desired outcomes. We aimed to investigate the prevalence and severity of psychological disorders in patients undergoing elective spine surgery.
  
  
  METHODS
  In this case-control study, associated psychological disorders were assessed using the Hospital Anxiety and Depression Scale (HADS) questionnaire at a single academic spine surgery center from August 2013 to June 2015. The case group consisted of 68 adult patients (mean age, 38.2 ± 9.6 years; male:female = 41:27) undergoing elective spine surgery and the control group included 69 healthy visitors of the orthopedic patients (mean age, 37.1 ± 6.9 years; male:female = 40:29) who voluntarily participated in the study. The 2 groups were compared for statistical analysis and a p-value < 5% was considered significance.
  
  
  RESULTS
  There was no statistically significant intergroup difference with regard to gender and age. The incidences of abnormal anxiety and depression were the same in the case group (14 patients, 20.6%). The values were 3 (4.3%) and 5 (7.2%), respectively, in the control group, showing statistically significant difference. Any association between the severity of depression and age or sex could not be identified.
  
  
  CONCLUSIONS
  In spite of spine surgeons' attempts to screen severe psychological disorders preoperatively, up to 21% of which cannot be diagnosed prior to elective spine surgery. Therefore, we believe the use of a questionnaire would be helpful in assessing patients' underlying psychological state before elective spine surgery.
authors.affiliation: Orthopedics Department, Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.; Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Farzad
authors.initials: F
authors.lastname: Omidi-Kashani
authors.affiliation: Psychiatric Department, Psychiatric and Behavioral Sciences Research Center, Ibn Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Faridhoseini
authors.affiliation: Department of Nuclear Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Shahrara
authors.initials: S
authors.lastname: Ariamanesh
authors.affiliation: Orthopedics Department, Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mahya Hashemi
authors.initials: MH
authors.lastname: Kazar
authors.affiliation: Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Aslan
authors.initials: A
authors.lastname: Baradaran
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis*; D016022:Case-Control Studies; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013131:Spine / Q000601:surgery*; D066231:Surgeons / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Anxiety; Depression; Psychiatric status; Spine; Surgery