Changes in postoperative depression and anxiety and their relationship with recovery from femoral head necrosis: A longitudinal study

Guo-Zheng Fang; Jie Lin; Lie-Hu Cao; Tong-Sheng Liu; Yu-Hong Ma; Lu Yang

doi:10.5498/wjp.v14.i10.1506

Changes in postoperative depression and anxiety and their relationship with recovery from femoral head necrosis: A longitudinal study

World J Psychiatry. 2024 Oct 19;14(10):1506-1512. doi: 10.5498/wjp.v14.i10.1506.

Authors

Guo-Zheng Fang¹, Jie Lin², Lie-Hu Cao¹, Tong-Sheng Liu¹, Yu-Hong Ma¹, Lu Yang³

Affiliations

¹ Department of Orthopedics, Shanghai Baoshan Luodian Hospital, Shanghai 201908, China.
² Department of Orthopedics, Shanghai Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China.
³ Department of Orthopedics, Shanghai Baoshan Luodian Hospital, Shanghai 201908, China. yl18601605776@126.com.

Abstract

Background: Femoral head necrosis (FHN) can significantly affect patients' psychological well-being and functional outcomes. However, the long-term relationship between postoperative depression, anxiety, and functional recovery in patients with FHN remains unclear.

Aim: To investigate the dynamic changes in postoperative depression and anxiety and their relationship with functional recovery in patients with FHN for 3 years.

Methods: Ninety-three patients with FHN who underwent surgical treatment in March 2020 to 2023 were enrolled in this longitudinal study. Depression and anxiety status were assessed using the hospital anxiety and depression scale (HADS) at baseline, 6 months, 1, 2, and 3 years postoperatively. Functional recovery was evaluated using the Harris hip score (HHS). The dynamic changes in HADS and HHS were analyzed using repeated measures ANOVA; the relationship between depression/anxiety status and functional recovery was examined using Pearson's correlation analysis.

Results: The mean HADS-depression (HADS-D) and HADS-anxiety (HADS-A) scores significantly improved over time (P < 0.001). The prevalence of depression and anxiety decreased from 36.6% and 41.9% at baseline to 10.8% and 12.9%, respectively, at 3 years postoperatively. The mean HHS increased significantly from 52.3 ± 10.5 at baseline to 88.1 ± 7.2 at 3 years postoperatively (P < 0.001). Significant negative correlations were found between HADS-D/HADS-A scores and HHS at all time points (P < 0.05).

Conclusion: The severity of depression and anxiety negatively correlated with functional recovery, highlighting the importance of psychological interventions in the management of patients with FHN.

Keywords: Femoral head necrosis; Functional recovery; Longitudinal study; Postoperative anxiety; Postoperative depression; Psychological intervention.