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Patients with depression and anxiety symptoms from adjustment disorder related to their shoulder may be ideal patients for arthroscopic rotator cuff repair.

Publication ,  Journal Article
Lau, BC; Scribani, M; Wittstein, J
Published in: J Shoulder Elbow Surg
July 2020

BACKGROUND: Mood symptoms may be due to shoulder-related depression or anxiety or clinical anxiety/depression. The objective of this study was to evaluate the relationship of shoulder-related and pre-existing diagnosis of depression or anxiety with changes in American Shoulder and Elbow Surgeons (ASES) score after rotator cuff repair. METHODS: A retrospective review of prospectively collected data on subjects undergoing arthroscopic rotator cuff repair was reviewed. Preoperative and postoperative ASES, questions from the Western Ontario Rotator Cuff index questions directed to feelings of depression/anxiety related to the shoulder, and pre-existing diagnoses of depression and/or anxiety were recorded. The Wilcoxon rank sum test was used to compare changes, and Spearman's correlation was used to correlate changes in mood and ASES between male and female subjects and those with and without anxiety and/or depression. RESULTS: One hundred seventy-one subjects (53 female; mean age, 58.0 years; standard deviation [SD], 8.5) who underwent arthroscopic rotator cuff repair were evaluated with the mean follow-up of 36.6 months (SD, 17.5). Forty-six subjects (mean age, 58.8 years; SD, 8.2) had pre-existing diagnoses of depression and/or anxiety and 125 subjects (mean age, 57.7 years; SD, 8.7) did not. Patients showed improvement in Western Ontario Rotator Cuff shoulder-related depression (Δ 22.3) and anxiety (Δ 24.7). There was a strong correlation between the change in mood symptoms and the change in ASES score, for depression (r = 0.74) and anxiety (r = 0.71). Patients with and without clinical diagnosis of anxiety or depression experienced similar changes in mood symptoms related to the shoulder and ASES scores (P = .65, P = .39). Patients' ASES scores were less correlated with changes in shoulder-related mood symptoms; however, if patients had clinical depression/anxiety compared with those without (r = 0.68 vs. 0.75, P < .0001 for depression; r = 0.56 vs. r = 0.74, P < .0001 for anxiety). CONCLUSIONS: After rotator cuff repair, symptoms of depression/anxiety related to the shoulder improved dramatically with or without pre-existing clinical diagnosis of depression or anxiety. As the patient-reported functional outcomes of those with pre-existing clinical diagnosis of anxiety/depression improved, they did not experience as strong as an improvement in their mood symptoms as those without prior diagnoses and may benefit from directed treatment of these symptoms. Patients with shoulder-related mood symptoms only, conversely, experience a strong relationship between their improvement in function with their mood symptoms and may be ideal candidates for rotator cuff surgery. It is important for clinicians to separate mood symptoms related to adjustment disorder from the rotator cuff injury from clinical depression and anxiety.

Duke Scholars

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

July 2020

Volume

29

Issue

7S

Start / End Page

S80 / S86

Location

United States

Related Subject Headings

  • Shoulder Joint
  • Sex Factors
  • Rotator Cuff Injuries
  • Rotator Cuff
  • Retrospective Studies
  • Psychiatric Status Rating Scales
  • Postoperative Period
  • Patient Reported Outcome Measures
  • Orthopedics
  • Middle Aged
 

Citation

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Lau, B. C., Scribani, M., & Wittstein, J. (2020). Patients with depression and anxiety symptoms from adjustment disorder related to their shoulder may be ideal patients for arthroscopic rotator cuff repair. J Shoulder Elbow Surg, 29(7S), S80–S86. https://doi.org/10.1016/j.jse.2020.03.046
Lau, Brian C., Melissa Scribani, and Jocelyn Wittstein. “Patients with depression and anxiety symptoms from adjustment disorder related to their shoulder may be ideal patients for arthroscopic rotator cuff repair.J Shoulder Elbow Surg 29, no. 7S (July 2020): S80–86. https://doi.org/10.1016/j.jse.2020.03.046.
Lau, Brian C., et al. “Patients with depression and anxiety symptoms from adjustment disorder related to their shoulder may be ideal patients for arthroscopic rotator cuff repair.J Shoulder Elbow Surg, vol. 29, no. 7S, July 2020, pp. S80–86. Pubmed, doi:10.1016/j.jse.2020.03.046.
Journal cover image

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

July 2020

Volume

29

Issue

7S

Start / End Page

S80 / S86

Location

United States

Related Subject Headings

  • Shoulder Joint
  • Sex Factors
  • Rotator Cuff Injuries
  • Rotator Cuff
  • Retrospective Studies
  • Psychiatric Status Rating Scales
  • Postoperative Period
  • Patient Reported Outcome Measures
  • Orthopedics
  • Middle Aged