Relevance of Diagnosed Depression and Antidepressants to PROMIS Depression Scores Among Hand Surgical Patients

被引:7
作者
Cochrane, Shannon [1 ]
Dale, Ann Marie [1 ]
Buckner-Petty, Skye [1 ]
Sobel, Andrew D. [2 ]
Lippold, Brandon [2 ]
Calfee, Ryan P. [2 ]
机构
[1] Washington Univ, Dept Med, Sch Med, St Louis, MO 63110 USA
[2] Washington Univ, Dept Orthopaed Surg, Sch Med, St Louis, MO 63110 USA
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 2021年 / 46卷 / 02期
关键词
Antidepressants; depression; hand; patient-reported outcomes; PROMIS; PRIMARY-CARE; PSYCHIATRIC COMORBIDITY; PERIOPERATIVE OUTCOMES; HEALTH; PREVALENCE; EFFICACY; ACCEPTABILITY; ASSOCIATION; MANAGEMENT; ADHERENCE;
D O I
10.1016/j.jhsa.2020.10.012
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose We aimed to test the utility of screening for depressive symptoms in the hand surgical office focusing on chances of heightened depressive symptoms in patients with no history of diagnosed depression and by quantifying ongoing depressive symptoms among patients diagnosed with depression accounting for antidepressant use. The clinical importance of this study was predicated on the documented negative association between depressive symptoms and hand surgical outcomes. Methods This cross-sectional study analyzed 351 patients presenting to a tertiary hand center between April 21, 2016, and November 22, 2017. Adult patients completed self-administered Patient-Reported Outcomes Measurement Information System (PROMIS) Depression computer adaptive tests at registration. Health records were examined for a past medical history of diagnosed depression and whether patients reported current use of prescription antidepressants. Mean PROMIS Depression scores were compared by analysis of variance (groups: no diagnosed depression, depression without medication, depression with medication). Four points represented a clinically relevant difference in PROMIS Depression scores between groups and Depression scores greater than 59.9 were categorized as having heightened depressive symptoms. Results Sixty-two patients (18%) had been diagnosed with depression. Thirty-four of these patients (55%) reported taking antidepressant medications. The PROMIS Depression scores indicated greater current depressive symptoms among patients with a history of diagnosed depression when not taking antidepressants (11 points worse than unaffected) and also among patients taking antidepressants (7 points worse than unaffected). Heightened depressive symptoms were detected in all groups but were more prevalent among those diagnosed with depression (36% with no medication, 29% with antidepressant medication) compared with unaffected patients (7%). Conclusions Depression screening for heightened depressive symptoms identifies 1 in 14 patients without diagnosed depression and 1 in 3 patients diagnosed with depression as having currently heightened depressive symptoms. Hand surgeons can use PROMIS Depression screening in all patients and using this to guide referrals for depression treatment to ameliorate one confounder of hand surgical outcomes. Copyright (C) 2021 by the American Society for Surgery of the Hand. All rights reserved.
引用
收藏
页码:99 / 105
页数:7
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