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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (2): 285-289. doi: 10.19723/j.issn.1671-167X.2020.02.015

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Analysis of anxiety, depression and related factors in patients with chronic lumbocrural pain before minimally invasive surgery

Duan YI,Wei ZHU,Xiu-li MENG,Xiao-guang LIU(),Shui-qing LI,Bin ZHU,Dong-lin JIA   

  1. Pain Medicine Department, Peking University Third Hospital, Beijing 100191, China
  • Received:2019-09-12 Online:2020-04-18 Published:2020-04-18
  • Contact: Xiao-guang LIU E-mail:xglius@vip.sina.com
  • Supported by:
    Supported by the Central Healthcare Scientific Research Fund(W2017BJ53)

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Abstract:

Objective: To investigate anxiety and/or depression status of patients with chronic lumbocrural pain, and to further analyze related risk factors of anxiety and/or depression .Methods: Retrospective analysis of the medical data of patients who suffered from chronic lumbocrural pain caused by lumbar disc herniation and/or lumbar spinal stenosis and received minimally invasive surgery from March 2018 to April 2018. General data (including age, gender, education levels, past history, sleep order and medical insurance), numeric rating scale(NRS), Japanese Orthopedic Association(JOA) back pain scale and hospital anxiety and depression scale(HADS) were collected for analysis. The basic demographic data and clinic data were analyzed, possible related risk factors associated were analyzed by univariate analysis, and multivariate Logistic regression analysis was further used to find the relative independent risk factors and included all the predictive variables with P values less than 0.05 as covariates.Results: A total of 91 patients met the inclusion criteria and finished this study, the mean HADS score for anxiety was 8.1±4.2, 48(52.7%) respondents were screened positive for anxiety, while the rest 43(47.3%) patients had negative anxiety state, the mean HDDS score for depression was 6.9±4.9, 38(41.8%) respondents were screened positive for depression, and the rest 53(58.2%) patients were not depressed, and 56(61.5%) patients experienced anxiety or depression. There were significant difference in sleep disorder, JOA score and leg NRS score between the patients with and without anxiety(P<0.05), and the significant differences were also found in age, sleep disorder and JOA score between the patients with and without depression(P<0.05), Logistic regression analysis further showed that the JOA score and sleep disorder were risk factors for anxiety, and the JOA score was risk factor for depression.Conclusion: Patients with chronic lumbocrural pain are often accompanied by anxiety and/or depression before minimally surgery, the low JOA score and sleep disturbance increased the risk of presenting anxiety, and the low JOA score increased the risk of developing depression. It is necessary to evaluate mental status and related risk factors before surgery.

Key words: Lumbocrural pain, Minimally invasive, Anxiety, Depression, Risk factors

CLC Number: 

  • R749.4

Table 1

Univariable analysis of related variables associated with anxiety/depression for patients suffered from chronic lumbocrural pain"

Items Anxiety Depression
Yes (n=48) No (n=43) P Yes (n=38) No (n=53) P
Gender, n(%)
Male 23(47.9) 27(62.8) 0.206a 19(50.0) 31(58.5) 0.522a
Female 25(52.1) 16(37.2) 19(50.0) 22(41.5)
Age/years, x?±s 54.8±17.2 52.9±19.8 0.636b 60.0±15.7 49.5±19.1 0.006b
Sleep disorder, n(%)
Yes 40(83.3) 21(48.8) 0.001a 31(81.6) 30(56.6) 0.014a
No 8(16.7) 22(51.2) 7(18.4) 23(43.4)
Diabetes, n(%)
Yes 7(14.6) 8(18.6) 0.778a 8(21.1) 7(13.2) 0.394a
No 41(85.4) 35(81.4) 30(78.9) 46(86.8)
CHD, n(%)
Yes 8(16.7) 3(7.0) 0.205a 7(18.4) 4(7.5) 1.191a
No 40(83.3) 40(93.0) 31(81.6) 49(92.5)
Hypertension, n(%)
Yes 13(37.1) 12(27.9) 1.000a 13(34.2) 12(22.6) 0.243a
No 35(62.9) 31(72.1) 25(75.8) 41(77.4)
Medical insurance, n(%)
Yes 9(18.8) 5(11.6) 0.408a 5(13.2) 9(17.0) 0.108a
No 39(81.2) 38(88.4) 33(86.8) 44(83.0)
Education levels, n(%)
Primary school 5(10.4) 2(4.6) 0.542a 3(7.9) 4(7.5) 0.974a
Junior middle school 8(16.7) 7(16.3) 6(15.8) 9(17.0)
Senior middle school 10(20.8) 10(23.3) 9(23.7) 11(20.8)
College 21(43.8) 16(37.2) 16(42.1) 21(39.6)
Above College 4(8.3) 8(18.6) 4(10.5) 8(15.1)
JOA score,$\bar{x}±s$ 10.6±5.6 15.4±5.9 0.000b 9.8±5.4 15.0±5.8 0.000b
NRS score,$\bar{x}±s$
Lumbar 5.4±3.2 4.8±2.4 0.304b 5.5±3.0 4.8±2.7 0.281b
Leg 6.3±3.1 5.0±2.7 0.041b 6.3±3.2 5.3±2.8 0.130b

Table 2

Multivariate Logistic regression analysis of variables associated with anxiety/depression for patients suffered from chronic lumbocrural pain"

Dependent variable Independent variable β Wald P OR R2
Anxiety
JOA score -0.114 7.105 0.008 0.892 0.200
Sleep disorder 1.226 5.450 0.020 3.407
Depression
JOA score -0.156 13.623 <0.001 0.855 0.167
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