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Article
Prevalence of symptoms of depression, anxiety, and posttraumatic stress disorder in workers with upper extremity complaints
Journal of Orthopaedic and Sports Physical Therapy
  • Ryan M. Degen, Hand and Upper Limb Centre
  • Joy C. Macdermid, Hand and Upper Limb Centre
  • Ruby Grewal, Hand and Upper Limb Centre
  • Darren S. Drosdowech, Hand and Upper Limb Centre
  • Kenneth J. Faber, Hand and Upper Limb Centre
  • George S. Athwal, Hand and Upper Limb Centre
Document Type
Article
Publication Date
7-1-2016
URL with Digital Object Identifier
10.2519/jospt.2016.6265
Abstract

Copyright ©2016 Journal of Orthopaedic & Sports Physical Therapy®. Fisheye STUDY DESIGN: Cross-sectional cohort study. Fisheye BACKGROUND: Symptoms of depression, panic disorder (PD), and posttraumatic stress disorder (PTSD) have been associated with musculoskeletal complaints and could represent barriers to recovery in injured workers. Fisheye OBJECTIVES: To determine the prevalence of symptoms of depression, PD, and PTSD utilizing the Patient Health Questionnaire (PHQ) in a cohort of patients presenting to an upper extremity injured-worker clinic; secondarily, to identify any relationships between patients screening positive and patient-reported outcome measures. Fisheye METHODS: In 2010, 418 patients completed the PHQ during their initial evaluation. Patients with PHQ scores exceeding threshold values for symptoms of depression, PD, or PTSD were compared based on patient-reported outcome scores, including the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The prevalence of symptoms, and their relationship with presenting complaints and patient-reported outcomes, were calculated. Fisheye RESULTS: Thirty-one percent of patients scored above thresholds for symptoms of at least 1 mental health disorder. Of those who screened positive, 67% screened positive for depression, 44% for PTSD, and 50% for PD, with 43% of patients positive for multiple symptoms. Patients experiencing neck pain had significantly higher screening rates of depressive symptoms (62.5% versus 20.1%, P = .004) and PD (37.5% versus 12.9%, P = .044) compared with other presenting complaints. Similarly, patients with chronic pain had higher rates of depression (54.5% versus 20.1%, P = .006), PD (63.6% versus 12%, P>.001), and PTSD (36.4% versus 14.8%, P = .05) compared with other presenting complaints. Patients endorsing depressive symptoms had significantly lower SF-36 mental component summary scores (26.3 ± 10.7 versus 37.6 ± 9.9, P<.001) and higher shortened-version DASH (72.3 ± 16.7 versus 61.5 ± 11.1, P = .003) and DASH work scores (86.5 ± 19.2 versus 82.1 ± 20.1, P = .007) compared to patients endorsing other items on the PHQ. Fisheye CONCLUSION: In this prospective cohort study of injured workers, we identified a relatively high prevalence of symptoms of psychological disorders utilizing the PHQ, with one third of injured workers screening positive for symptoms of depression, PD, or PTSD. Further longitudinal follow-up is necessary to determine the impact on treatment outcomes. Fisheye LEVEL OF EVIDENCE: Symptom prevalence, level 1b.

Notes
Article is freely available at the journal
Citation Information
Ryan M. Degen, Joy C. Macdermid, Ruby Grewal, Darren S. Drosdowech, et al.. "Prevalence of symptoms of depression, anxiety, and posttraumatic stress disorder in workers with upper extremity complaints" Journal of Orthopaedic and Sports Physical Therapy Vol. 46 Iss. 7 (2016) p. 590 - 595
Available at: http://works.bepress.com/joy-macdermid/136/