Wang Bo, Shi Da, Sun Yin-Di, Dong Bo
Joint Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China.
Pain Ward of Orthopedics Department of TCM, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, Shaanxi Province, China.
World J Psychiatry. 2025 Jan 19;15(1):101373. doi: 10.5498/wjp.v15.i1.101373.
Traumatic injuries, such as falling, car accidents, and crushing mostly cause spinal fractures in young and middle-aged people, and > 50% of them are thoracolumbar fractures. This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues, which causes paralysis of the lower limbs if there is no timely rehabilitation treatment. Young patients with thoracolumbar fractures find it difficult to recover after the operation, and they are prone to depression, low self-esteem, and other negative emotions.
To investigate the association between anxiety, depression, and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes.
This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital, Xi'an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023. The general data of the patients were assessed with the Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), life events scale, and social support rating scale (SSRS) to identify the correlation between anxiety, depression scores, and social stress and social support. The Japanese Orthopedic Association (JOA) was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation.
According to the scores of HAMD and HAMA in all patients, the prevalence of depression in patients was 39% (39/100), and the prevalence of anxiety was 49% (49/100). Patients were categorized into non-depression ( = 61) and depression ( = 39), non-anxiety ( = 51), and anxiety ( = 49) groups. Statistically significant differences in gender, occupation, Pittsburgh Sleep Quality Index (PSQI) score, and monthly family income were observed between the non-depression and depression groups ( < 0.05). A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups. Both depression ( = 0.207, = 0.038) and anxiety scores ( = 0.473, < 0.001) were significantly and positively correlated with negative life events. The difference in negative life event scores as well as SSRS total and item scores was statistically significant between patients in the non-depression and depression groups ( < 0.05). The difference between the non-anxiety and anxiety groups was statistically significant ( < 0.05) in the negative life event scores as well as the total SSRS scores. Additionally, JOA scores were significantly lower in both anxious and depressed patients.
Young patients with thoracolumbar fractures are prone to anxiety and depression. Patients' anxiety and depression are closely associated with social pressure, which reduces the life pressure of young patients with thoracolumbar fractures, enhances social support, and improves the psychology of anxiety and depression., which affects patients' recovery.
创伤性损伤，如跌倒、车祸和挤压伤，大多导致中青年脊柱骨折，其中超过50%为胸腰椎骨折。这类骨折易合并周围神经和软组织严重损伤，若不及时进行康复治疗，会导致下肢瘫痪。胸腰椎骨折的年轻患者术后恢复困难，且容易出现抑郁、自卑等负面情绪。
探讨胸腰椎骨折年轻患者焦虑、抑郁与社会压力之间的关联以及对康复结局的影响。
本研究回顾性分析了2022年1月至2023年6月在西安交通大学附属红会医院骨科接受胸腰椎骨折手术的100例患者。采用汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）、生活事件量表和社会支持评定量表（SSRS）对患者的一般资料进行评估，以确定焦虑、抑郁评分与社会压力和社会支持之间的相关性。采用日本骨科协会（JOA）评分评估患者的康复结局，并分析焦虑和抑郁评分对康复的影响。
根据所有患者的HAMD和HAMA评分，患者中抑郁的患病率为39%（39/100），焦虑的患病率为49%（49/100）。患者被分为非抑郁（=61）和抑郁（=39）组、非焦虑（=51）和焦虑（=49）组。非抑郁组和抑郁组在性别、职业、匹兹堡睡眠质量指数（PSQI）评分和家庭月收入方面存在统计学显著差异（<0.05）。非焦虑组和焦虑组在职业和PSQI评分方面存在显著差异。抑郁评分（=0.207，=0.038）和焦虑评分（=0.473，<0.001）均与负性生活事件显著正相关。非抑郁组和抑郁组患者在负性生活事件评分以及SSRS总分和各项目评分方面的差异具有统计学意义（<0.05）。非焦虑组和焦虑组在负性生活事件评分以及SSRS总分方面的差异具有统计学意义（<0.05）。此外，焦虑和抑郁患者的JOA评分均显著较低。
胸腰椎骨折的年轻患者容易出现焦虑和抑郁。患者的焦虑和抑郁与社会压力密切相关，减轻胸腰椎骨折年轻患者的生活压力，增强社会支持，改善焦虑和抑郁心理，会影响患者的康复。
