CORR Insights®: Operative Treatment is Not Associated with More Relief of Depression Symptoms than Nonoperative Treatment in Patients with Common Hand Illness

摘要

There has been substantial discussion during the past 20 years regarding the association among depression, pain interference, and functional results after orthopaedic surgery. For instance, a study [11] determined that the psychosocial correlates of disabling musculoskeletal pain are comparable to those in patients with conditions such as headaches, fibromyalgia, and irritable bowel syndrome. We also know that in patients who have sustained musculoskeletal trauma, psychological factors such as anxiety, depression, and a tendency towards catastrophic thinking are strongly associated with worsening pain intensity and disability [10]. Another study [9] has reported that 12% of patients presenting to a hand surgeon with one or more hand conditions (such as carpal tunnel syndrome, ganglion cyst, trigger finger, and unspecified hand pain) have untreated and undertreated symptoms of depression sufficient to qualify for an estimated diagnosis of major depression. Moreover, in patients with atraumatic hand conditions, increased pain intensity before treatment was associated with increased depression symptoms and pain catastrophizing [7]. Most experienced hand surgeons know that a patient’s recovery and level of pain after hand surgery can be influenced by the patient’s depression symptoms, and thus, these symptoms can directly affect the outcomes of hand surgery [3, 5, 12].