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Self-rated hand function improved in patients with depression, pain catastrophization after treatment
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Patients with atraumatic hand/wrist conditions affected by depression or pain catastrophization showed similar absolute improvement in self-rated hand function following treatment compared with patients with unaffected status, according to study results.
Researchers enrolled 256 patients who presented to an orthopaedic hand clinic and were prescribed treatment for atraumatic hand/wrist conditions. All patients completed the Center for Epidemiologic Studies Depression scale, the Pain Catastrophizing Scale and the Michigan Hand Outcomes Questionnaire (MHQ) at enrollment. Patients completed the MHQ again 1 and 3 months after treatment.
The researchers categorized participants’ psychological comorbidity status as either affected or unaffected and examined diagnoses and treatments for both groups. Fifty patients were classified as affected, whereas 206 were unaffected.
A significantly higher mean MHQ score was seen among the unaffected group compared with the affected group at the time of enrollment. From baseline to 3 months after treatment, both groups demonstrated similar significant absolute improvement, according to the researchers, making the rating of hand function still significantly poorer among affected patients at final follow-up.
“It has been hypothesized that assessing patient depression and pain catastrophization, and treating it, may lead to improved surgical outcomes, limit unnecessary interventions, reduce pain, and increase quality of life,” the researchers wrote. “Prior studies have demonstrated that treatment of depression and pain catastrophization with cognitive behavioral therapy has led to improved psychological outcomes and reduction in pains scores for patients with chronic back pain, fibromyalgia, temporomandibular pain, and other chronic pain complaints. Additional studies are warranted to determine if psychological treatment can result in even greater improvement in patient-rated hand function for affected patients.”
Disclosures: London received grant and travel support from the Doris Duke Charitable Foundation. Stepan received grant support from TL1 Pre-doctoral Scholar. Boyer is a consultant for MiMedX LLC and Acumed LLC, provided expert testimony for Hand Surgical Medicolegal Consultation LLC, received royalties from Wolters-Kluwer Publishers and has stock options in Tornier and OrthoHelix.
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