Do Pa tie nts with De pre ssio n o r Anxie ty E xpe rie nc e Gre a te r L e ve ls o f Pa in Ca ta stro phizing ? Me g a n Simo n MA, L AT , AT C, OT C PI : Jo hn Xe ro g e a ne s, MD, Je nnife r Hunnic utt, PhD
BACKGROUND • Hig h c o mo rb idity o f a nxie ty a nd de pre ssio n we ll e sta b lishe d in the lite ra ture 1,2,3 • I nc re a se in de pre ssio n se e n po st injury 4 • Sig nific a nt pa in no te d a fte r ACL injury
BACKGROUND • Pa in Ca ta stro phizing 5 • Ca sc a de o f ne g a tive re spo nse s (c o g nitive a nd e mo tio na l) in a ntic ipa tio n o f pa in • Adve rse ly a ffe c ts pa in c o ping b e ha vio r • Ho w is pa in re la te d to de pre ssio n a nd a nxie ty a fte r ACL injury?
OBJE CT IVE S • Co mpa re pa tie nts de pre ssio n a nd o r a nxie ty sympto ms to Pa in Ca ta stro phizing Sc o re s (PCS) b e fo re ACL re c o nstruc tio n. • Hypothe sis: Pa tie nts with hig he r le ve ls o f de pre ssio n a nd/ o r a nxie ty will de mo nstra te a g re a te r PCS prio r to ACL re c o nstruc tio n.
ME T HODOL OGY • Co nse c utive pa tie nts unde rg o ing ACL Re c o nstruc tio n (n=35) b y a sing le surg e o n in 2020 we re pro spe c tive ly fo llo we d. • Prima ry a nd se c o nda ry ACL Re c o nstruc tio n we re inc lude d • Prio r surg e ry, pa tie nts we re a dministe re d PCS a nd PROMI S De pre ssio n a nd Anxie ty surve ys
ME T HODOL OGY PROMIS Sur ve ys PCS Sur ve y
ME T HODOL OGY
RE SUL T S • 35 pa rtic ipa nts • Ave ra g e a g e 27.5 ( ± 11.1) • F e ma le s (n=16) ANX DEP PCS • Ma le s (n=19) AVE 6.34 4.89 6.09 STDEV 2.79 2.15 9.05 • Mo de ra te , Po sitive Co rre la tio n b e twe e n Anxie ty a nd De pre ssio n • r(35) = 0.56
RE SUL T S Pain vs Anxiety Scores 40 35 30 25 We a k, Po sitive Co rre la tio n PCS Total 20 b e twe e n Anxie ty a nd PCS r(35) = 0.28 15 10 5 0 0 2 4 6 8 10 12 14 -5 PROMIS Anxiety Total
RE SUL T S Pain vs Depression Scores 40 35 30 25 Mo de ra te , Po sitive Co rre la tio n 20 PCS Total b e twe e n De pre ssio n a nd PCS r(35) = 0.47 15 10 5 0 0 2 4 6 8 10 12 14 16 -5 PROMIS Depression Total
CONCL USIONS F inding s Clinic a l I mplic a tio ns • Mo de ra te c o rre la tio ns • Administra tio n o f de pre ssio n b e twe e n de pre ssio n a nd PCS a nd a nxie ty q ue stio nna ire s • Co nside ra tio ns fo r pa tie nts prio r to surg e ry with pre -e xisting de pre ssio n/ a nxie ty L imita tio ns F uture Re se a rc h Sa mple size • RCT - re la tio nship b e twe e n • Surve y a dministra tio n de pre ssio n/ a nxie ty a nd o pio id • during pre -o p use
RE F E RE NCE S 1. Bje lla nd I , Da hl AA, Ha ug T T , Ne c ke lma nn D. T he va lidity o f the Ho spita l Anxie ty a nd De pre ssio n Sc a le . J Psyc ho so m Re s . 2002;52(2):69-77. do i:10.1016/ s0022- 3999(01)00296-3 2. Ste e r RA, Cla rk DA, K uma r G, Be c k AT . Co mmo n a nd spe c ific dime nsio ns o f se lf- re po rte d a nxie ty a nd de pre ssio n in a do le sc e nt o utpa tie nts. J Psyc ho patho l Be hav Asse ss . 2008;30(3):163-170. do i:10.1007/ s10862-007-9060-2 3. Cla rk L A, Wa tso n D. T ripa rtite mo de l o f a nxie ty a nd de pre ssio n: Psyc ho me tric e vide nc e a nd ta xo no mic implic a tio ns. J Ab no rm Psyc ho l . 1991;100(3):316-336. do i:10.1037/ / 0021-843x.100.3.316 4. Appa ne a l RN, L e vine BR, Pe rna F M, Ro h JL . Me a suring Po stinjury De pre ssio n a mo ng Ma le a nd F e ma le Co mpe titive Athle te s. J Spo rt E xe rc Psyc ho l . 2009;31(1):60-76. do i:10.1123/ jse p.31.1.60 5. L e ung L . Pa in c a ta stro phizing : a n upda te d re vie w. I ndian J Psyc ho l Me d . 2012;34(3):204 ‐ 217. do i:10.4103/ 0253-7176.106012
T HANK YOU! Me g a n Simo n MA, L AT , AT C, OT C mb simo 2@ e mo ry.e du
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