Anxiety and depression in spine surgery – a systematic integrative review

Publication date: Available online 9 April 2018
Source:The Spine Journal
Author(s): Janni Strøm, Merete B. Bjerrum, Claus V. Nielsen, Cecilie N. Thisted, Tove L. Nielsen, Malene Laursen, Lene B. Jørgensen
BackgroundSymptoms of preoperative anxiety and depression occur in approximately one-third of patients with chronic back pain undergoing surgery. In the last 2 decades, several studies have established that preoperative anxiety and depression are important outcome predictors of greater pain and physical impairments, and lower health-related quality of life in patients undergoing spine surgery. To accommodate symptoms of anxiety and depression and thereby better surgical outcomes, we need to identify factors associated with these symptoms.PurposeTo identify factors associated with symptoms of anxiety and depression in adults both before and after undergoing spinal surgery.Study designIntegrative literature reviewMethodsThe independent charity Helsefonden supported this literature review by contributing $45,000 to remunerate a dedicated investigator. A systematic literature search was conducted in PubMed, CINAHL, PsycINFO, Embase, Scopus, Cochrane, and Web of Science. A three-step selection and assessment process was conducted; titles and abstracts of 1124 articles were skimmed for relevance, of these 53 articles were found to be of relevance and were read in full. Articles not meeting the inclusion criteria (n=26) were excluded. The 31 articles were critically appraised for methodological validity; 14 of these were synthesized and analyzed using a convergent qualitative design to transform both qualitative and quantitative articles into qualitative findings.ResultsFourteen studies were included, reporting results based on 4,833 participants, 3,017 males and 1,816 females, whose mean age was approximately 49 years. From these results, we extracted 75 individual findings, which we then divided into five categories of factors associated with anxiety and depression both before and after undergoing spine surgery: pain, information, disability, employment, and mental health.ConclusionsFive categories of interacting factors that influenced symptoms of anxiety and depression both before and after surgery were identified: pain, lack of information, disability, return to work, and mental health. Information appears to have a regulating effect on anxiety and depression.



https://ift.tt/2Ey7G4O