Fang Guo-Zheng, Lin Jie, Cao Lie-Hu, Liu Tong-Sheng, Ma Yu-Hong, Yang Lu
Department of Orthopedics, Shanghai Baoshan Luodian Hospital, Shanghai 201908, China.
Department of Orthopedics, Shanghai Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China.
World J Psychiatry. 2024 Oct 19;14(10):1506-1512. doi: 10.5498/wjp.v14.i10.1506.
Femoral head necrosis (FHN) can significantly affect patients' psychological well-being and functional outcomes. However, the long-term relationship between postoperative depression, anxiety, and functional recovery in patients with FHN remains unclear.
To investigate the dynamic changes in postoperative depression and anxiety and their relationship with functional recovery in patients with FHN for 3 years.
Ninety-three patients with FHN who underwent surgical treatment in March 2020 to 2023 were enrolled in this longitudinal study. Depression and anxiety status were assessed using the hospital anxiety and depression scale (HADS) at baseline, 6 months, 1, 2, and 3 years postoperatively. Functional recovery was evaluated using the Harris hip score (HHS). The dynamic changes in HADS and HHS were analyzed using repeated measures ANOVA; the relationship between depression/anxiety status and functional recovery was examined using Pearson's correlation analysis.
The mean HADS-depression (HADS-D) and HADS-anxiety (HADS-A) scores significantly improved over time ( < 0.001). The prevalence of depression and anxiety decreased from 36.6% and 41.9% at baseline to 10.8% and 12.9%, respectively, at 3 years postoperatively. The mean HHS increased significantly from 52.3 ± 10.5 at baseline to 88.1 ± 7.2 at 3 years postoperatively ( < 0.001). Significant negative correlations were found between HADS-D/HADS-A scores and HHS at all time points ( < 0.05).
The severity of depression and anxiety negatively correlated with functional recovery, highlighting the importance of psychological interventions in the management of patients with FHN.
股骨头坏死（FHN）会显著影响患者的心理健康和功能预后。然而，FHN患者术后抑郁、焦虑与功能恢复之间的长期关系仍不明确。
研究FHN患者术后3年内抑郁和焦虑的动态变化及其与功能恢复的关系。
本纵向研究纳入了93例于2020年3月至2023年接受手术治疗的FHN患者。在基线、术后6个月、1年、2年和3年时，使用医院焦虑抑郁量表（HADS）评估抑郁和焦虑状态。使用Harris髋关节评分（HHS）评估功能恢复情况。采用重复测量方差分析分析HADS和HHS的动态变化；使用Pearson相关分析检验抑郁/焦虑状态与功能恢复之间的关系。
HADS抑郁（HADS-D）和HADS焦虑（HADS-A）的平均得分随时间显著改善（<0.001）。抑郁和焦虑的患病率分别从基线时的36.6%和41.9%降至术后3年时的10.8%和12.9%。HHS的平均分从基线时的52.3±10.5显著提高至术后3年时的88.1±7.2（<0.001）。在所有时间点，HADS-D/HADS-A得分与HHS之间均存在显著负相关（<0.05）。
抑郁和焦虑的严重程度与功能恢复呈负相关，突出了心理干预在FHN患者管理中的重要性。
