Zieger M, Schwarz R, König H-H, Härter M, Riedel-Heller S G
Department of Psychiatry, Public Health Research Unit, University of Leipzig, Leipzig, Germany.
Cent Eur Neurosurg. 2010 Feb;71(1):26-34. doi: 10.1055/s-0029-1225325. Epub 2010 Jan 21.
An association between depression and anxiety and musculoskeletal disorders has been consistently reported in the past years. This article provides a systematic overview of the literature on the prevalence rates of depression and anxiety in patients undergoing surgery for a herniated disc.
A systematic literature search was conducted in the following electronic databases: PubMed, PsycINFO, Web of Science, Cochrane Library and PSYNDEXplus. The identified articles were evaluated for prevalence rates of depression and anxiety, methodological issues, change of depression and anxiety over time, and major findings on the impact of depression and anxiety on patients undergoing disc surgery.
Fourteen studies were identified. Prevalence rates for depression and anxiety in patients undergoing disc surgery varied between 21.5% and 49.3% before and between 4.1% and 79.6% after disc surgery. The study designs, the use of assessment instruments and cut-off values varied greatly. Depression and anxiety decreased within the population of disc surgery patients over time. Depression and anxiety were found to have a great impact on the postoperative outcome of surgery, return to work, analgesia abuse, pain experience, and abnormal illness behaviour.
Little research has been done to investigate depression and anxiety in patients undergoing surgery for a herniated disc. Evidently disc surgery patients are at higher risk of suffering from depression and anxiety than the general population. The review outlines the importance for clinicians to be more sensitive to psychological concerns in patients undergoing disc surgery. Psychological assessment and assistance from mental health professionals should be considered during the hospital stay and rehabilitation period, depending on local feasibility. Further investigations are necessary to examine whether the implementation of a multidisciplinary in-patient treatment program will improve postoperative outcome in patients undergoing intervertebral disc surgery.
过去几年中，抑郁症、焦虑症与肌肉骨骼疾病之间的关联一直被报道。本文系统综述了有关椎间盘突出症手术患者中抑郁症和焦虑症患病率的文献。
在以下电子数据库中进行了系统的文献检索：PubMed、PsycINFO、科学网、Cochrane图书馆和PSYNDEXplus。对纳入的文章进行评估，内容包括抑郁症和焦虑症的患病率、方法学问题、抑郁症和焦虑症随时间的变化，以及抑郁症和焦虑症对椎间盘手术患者影响的主要研究结果。
共识别出14项研究。椎间盘手术患者术前抑郁症和焦虑症的患病率在21.5%至49.3%之间，术后在4.1%至79.6%之间。研究设计、评估工具的使用和临界值差异很大。随着时间推移，椎间盘手术患者群体中的抑郁症和焦虑症有所减轻。抑郁症和焦虑症被发现对手术的术后结果、重返工作岗位、镇痛药物滥用、疼痛体验和异常疾病行为有很大影响。
针对椎间盘突出症手术患者的抑郁症和焦虑症的研究较少。显然，椎间盘手术患者患抑郁症和焦虑症的风险高于普通人群。该综述强调了临床医生对椎间盘手术患者心理问题更加敏感的重要性。根据当地实际情况，在住院期间和康复期应考虑进行心理评估并获得心理健康专业人员的帮助。有必要进一步研究多学科住院治疗方案的实施是否会改善椎间盘手术患者的术后结果。
