Impact of Depression and Bipolar Disorders on Functional and Quality of Life Outcomes in Patients Undergoing Surgery for Degenerative Cervical Myelopathy: Analysis of a Combined Prospective Dataset
STUDY DESIGN.Analysis of a combined prospective dataset. OBJECTIVE.To compare clinical outcomes in patients with and without preexisting depression or bipolar disorder undergoing surgery for degenerative cervical myelopathy (DCM). SUMMARY OF BACKGROUND DATA.Psychiatric co-morbidities, including depr...
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| Veröffentlicht in: | Spine (Philadelphia, Pa. 1976) Pa. 1976), 2017-03, Vol.42 (6), p.372-378 |
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| creator | Tetreault, Lindsay Nagoshi, Narihito Nakashima, Hiroaki Singh, Anoushka Kopjar, Branko Arnold, Paul Fehlings, Michael G. |
| description | STUDY DESIGN.Analysis of a combined prospective dataset.
OBJECTIVE.To compare clinical outcomes in patients with and without preexisting depression or bipolar disorder undergoing surgery for degenerative cervical myelopathy (DCM).
SUMMARY OF BACKGROUND DATA.Psychiatric co-morbidities, including depression, have been associated with worse clinical outcomes following lumbar spine surgery; however, it is unclear whether these psychiatric disorders are also predictive of outcomes in patients undergoing surgery for the treatment of DCM.
METHODS.Four hundred and one patients with symptomatic DCM were enrolled in the prospective AOSpine International or North America study at twelve North American sites. Patients were evaluated preoperatively and at 6-, 12- and 24-months using the modified Japanese Orthopedic Association scale (mJOA), Nurick score, Neck Disability Index (NDI), and Short- Form 36v2 (SF-36) Health Survey. A mixed model analytic approach was used to evaluate differences in outcomes at 24-months between patients with and without psychiatric disorders, while controlling for relevant baseline characteristics and surgical factors.
RESULTS.Ninety-seven patients (24.19%) were diagnosed with preexisting depression or bipolar disorder. There were more females (65.98%) with these psychiatric disorders than males (34.02%) (p |
| doi_str_mv | 10.1097/BRS.0000000000001777 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826714756</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826714756</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2807-9ee3ec9f38f6f18210cea1975dbd7a89c5fc5d90d4460422c169c7b2858681eb3</originalsourceid><addsrcrecordid>eNqFks1u1DAURiMEokPhDRDykk2KHSf-YdfOUKg0qIXSdeQ4NzOGxA620yoPyHvhdApCLMAbS_Y537X0OcteEnxCsORvzj5fn-A_FuGcP8pWpCpETkglH2crTFmRFyVlR9mzEL4miFEin2ZHBadSCElW2Y-LYVQ6ItehDYweQjDOImVbdGZG1yuPNiY434IPKF2cT1bHRKj-nvk0qd7EebG3pgN0OUXtBgjIWHSlogEbA7qxyd45Y3foevI78DPqXMqFHVjwiboFtAZ_a3RK_ThD70YV9_NbdJrGzMGEJV6htRsaY6FFV96FEfS9t1FRBYjPsyed6gO8eNiPs5vzd1_WH_Lt5fuL9ek214XAPJcAFLTsqOhYR0RBsAZFJK_apuVKSF11umolbsuS4bIoNGFS86YQlWCCQEOPs9eH3NG77xOEWA8maOh7ZcFNoU6ZjJOSVyyh5QHV6bnBQ1eP3gzKzzXB9VJgnQqs_y4waa8eJkzNAO1v6VdjCRAH4M71MbXyrZ_uwNd7UH3c_y-7_Ie6YJzR9GESjSmpcL4cCfoTjOy68A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1826714756</pqid></control><display><type>article</type><title>Impact of Depression and Bipolar Disorders on Functional and Quality of Life Outcomes in Patients Undergoing Surgery for Degenerative Cervical Myelopathy: Analysis of a Combined Prospective Dataset</title><source>Journals@Ovid Ovid Autoload</source><source>MEDLINE</source><creator>Tetreault, Lindsay ; Nagoshi, Narihito ; Nakashima, Hiroaki ; Singh, Anoushka ; Kopjar, Branko ; Arnold, Paul ; Fehlings, Michael G.</creator><creatorcontrib>Tetreault, Lindsay ; Nagoshi, Narihito ; Nakashima, Hiroaki ; Singh, Anoushka ; Kopjar, Branko ; Arnold, Paul ; Fehlings, Michael G.</creatorcontrib><description>STUDY DESIGN.Analysis of a combined prospective dataset.
OBJECTIVE.To compare clinical outcomes in patients with and without preexisting depression or bipolar disorder undergoing surgery for degenerative cervical myelopathy (DCM).
SUMMARY OF BACKGROUND DATA.Psychiatric co-morbidities, including depression, have been associated with worse clinical outcomes following lumbar spine surgery; however, it is unclear whether these psychiatric disorders are also predictive of outcomes in patients undergoing surgery for the treatment of DCM.
METHODS.Four hundred and one patients with symptomatic DCM were enrolled in the prospective AOSpine International or North America study at twelve North American sites. Patients were evaluated preoperatively and at 6-, 12- and 24-months using the modified Japanese Orthopedic Association scale (mJOA), Nurick score, Neck Disability Index (NDI), and Short- Form 36v2 (SF-36) Health Survey. A mixed model analytic approach was used to evaluate differences in outcomes at 24-months between patients with and without psychiatric disorders, while controlling for relevant baseline characteristics and surgical factors.
RESULTS.Ninety-seven patients (24.19%) were diagnosed with preexisting depression or bipolar disorder. There were more females (65.98%) with these psychiatric disorders than males (34.02%) (p < 0.0001). Patients with psychiatric co-morbidities were more likely to have cardiovascular (p = 0.0177), respiratory (p < 0.0001), gastrointestinal (p < 0.0001), rheumatologic (p = 0.0109) and neurologic (p = 0.0309) disorders. At 24-months following surgery, patients in both groups demonstrated significant improvements on the mJOA, Nurick, NDI and SF-36 Physical Component Score (PCS). Patients with depression or bipolar disorder, however, did not exhibit a significant or clinically important change on the SF-36 Mental Component Score (MCS). There were no differences in mJOA and Nurick scores at 24-months between patients in each group. Improvement in NDI, SF-36 PCS and MCS, however, were smaller in patients with depression or bipolar disorder than those without.
CONCLUSIONS.Patients with depression or bipolar disorder have smaller functional and quality of life improvements following surgery compared to patients without psychiatric co-morbidities</description><identifier>ISSN: 0362-2436</identifier><identifier>EISSN: 1528-1159</identifier><identifier>DOI: 10.1097/BRS.0000000000001777</identifier><identifier>PMID: 27398891</identifier><language>eng</language><publisher>United States: Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Bipolar Disorder - complications ; Cervical Vertebrae - surgery ; Decompression, Surgical - methods ; Depression - complications ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Quality of Life ; Spinal Cord Diseases - surgery ; Spinal Fusion - adverse effects ; Spinal Fusion - methods ; Treatment Outcome</subject><ispartof>Spine (Philadelphia, Pa. 1976), 2017-03, Vol.42 (6), p.372-378</ispartof><rights>Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2807-9ee3ec9f38f6f18210cea1975dbd7a89c5fc5d90d4460422c169c7b2858681eb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27398891$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tetreault, Lindsay</creatorcontrib><creatorcontrib>Nagoshi, Narihito</creatorcontrib><creatorcontrib>Nakashima, Hiroaki</creatorcontrib><creatorcontrib>Singh, Anoushka</creatorcontrib><creatorcontrib>Kopjar, Branko</creatorcontrib><creatorcontrib>Arnold, Paul</creatorcontrib><creatorcontrib>Fehlings, Michael G.</creatorcontrib><title>Impact of Depression and Bipolar Disorders on Functional and Quality of Life Outcomes in Patients Undergoing Surgery for Degenerative Cervical Myelopathy: Analysis of a Combined Prospective Dataset</title><title>Spine (Philadelphia, Pa. 1976)</title><addtitle>Spine (Phila Pa 1976)</addtitle><description>STUDY DESIGN.Analysis of a combined prospective dataset.
OBJECTIVE.To compare clinical outcomes in patients with and without preexisting depression or bipolar disorder undergoing surgery for degenerative cervical myelopathy (DCM).
SUMMARY OF BACKGROUND DATA.Psychiatric co-morbidities, including depression, have been associated with worse clinical outcomes following lumbar spine surgery; however, it is unclear whether these psychiatric disorders are also predictive of outcomes in patients undergoing surgery for the treatment of DCM.
METHODS.Four hundred and one patients with symptomatic DCM were enrolled in the prospective AOSpine International or North America study at twelve North American sites. Patients were evaluated preoperatively and at 6-, 12- and 24-months using the modified Japanese Orthopedic Association scale (mJOA), Nurick score, Neck Disability Index (NDI), and Short- Form 36v2 (SF-36) Health Survey. A mixed model analytic approach was used to evaluate differences in outcomes at 24-months between patients with and without psychiatric disorders, while controlling for relevant baseline characteristics and surgical factors.
RESULTS.Ninety-seven patients (24.19%) were diagnosed with preexisting depression or bipolar disorder. There were more females (65.98%) with these psychiatric disorders than males (34.02%) (p < 0.0001). Patients with psychiatric co-morbidities were more likely to have cardiovascular (p = 0.0177), respiratory (p < 0.0001), gastrointestinal (p < 0.0001), rheumatologic (p = 0.0109) and neurologic (p = 0.0309) disorders. At 24-months following surgery, patients in both groups demonstrated significant improvements on the mJOA, Nurick, NDI and SF-36 Physical Component Score (PCS). Patients with depression or bipolar disorder, however, did not exhibit a significant or clinically important change on the SF-36 Mental Component Score (MCS). There were no differences in mJOA and Nurick scores at 24-months between patients in each group. Improvement in NDI, SF-36 PCS and MCS, however, were smaller in patients with depression or bipolar disorder than those without.
CONCLUSIONS.Patients with depression or bipolar disorder have smaller functional and quality of life improvements following surgery compared to patients without psychiatric co-morbidities</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bipolar Disorder - complications</subject><subject>Cervical Vertebrae - surgery</subject><subject>Decompression, Surgical - methods</subject><subject>Depression - complications</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Spinal Cord Diseases - surgery</subject><subject>Spinal Fusion - adverse effects</subject><subject>Spinal Fusion - methods</subject><subject>Treatment Outcome</subject><issn>0362-2436</issn><issn>1528-1159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks1u1DAURiMEokPhDRDykk2KHSf-YdfOUKg0qIXSdeQ4NzOGxA620yoPyHvhdApCLMAbS_Y537X0OcteEnxCsORvzj5fn-A_FuGcP8pWpCpETkglH2crTFmRFyVlR9mzEL4miFEin2ZHBadSCElW2Y-LYVQ6ItehDYweQjDOImVbdGZG1yuPNiY434IPKF2cT1bHRKj-nvk0qd7EebG3pgN0OUXtBgjIWHSlogEbA7qxyd45Y3foevI78DPqXMqFHVjwiboFtAZ_a3RK_ThD70YV9_NbdJrGzMGEJV6htRsaY6FFV96FEfS9t1FRBYjPsyed6gO8eNiPs5vzd1_WH_Lt5fuL9ek214XAPJcAFLTsqOhYR0RBsAZFJK_apuVKSF11umolbsuS4bIoNGFS86YQlWCCQEOPs9eH3NG77xOEWA8maOh7ZcFNoU6ZjJOSVyyh5QHV6bnBQ1eP3gzKzzXB9VJgnQqs_y4waa8eJkzNAO1v6VdjCRAH4M71MbXyrZ_uwNd7UH3c_y-7_Ie6YJzR9GESjSmpcL4cCfoTjOy68A</recordid><startdate>20170315</startdate><enddate>20170315</enddate><creator>Tetreault, Lindsay</creator><creator>Nagoshi, Narihito</creator><creator>Nakashima, Hiroaki</creator><creator>Singh, Anoushka</creator><creator>Kopjar, Branko</creator><creator>Arnold, Paul</creator><creator>Fehlings, Michael G.</creator><general>Wolters Kluwer Health, Inc. All rights reserved</general><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170315</creationdate><title>Impact of Depression and Bipolar Disorders on Functional and Quality of Life Outcomes in Patients Undergoing Surgery for Degenerative Cervical Myelopathy: Analysis of a Combined Prospective Dataset</title><author>Tetreault, Lindsay ; Nagoshi, Narihito ; Nakashima, Hiroaki ; Singh, Anoushka ; Kopjar, Branko ; Arnold, Paul ; Fehlings, Michael G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2807-9ee3ec9f38f6f18210cea1975dbd7a89c5fc5d90d4460422c169c7b2858681eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bipolar Disorder - complications</topic><topic>Cervical Vertebrae - surgery</topic><topic>Decompression, Surgical - methods</topic><topic>Depression - complications</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Spinal Cord Diseases - surgery</topic><topic>Spinal Fusion - adverse effects</topic><topic>Spinal Fusion - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tetreault, Lindsay</creatorcontrib><creatorcontrib>Nagoshi, Narihito</creatorcontrib><creatorcontrib>Nakashima, Hiroaki</creatorcontrib><creatorcontrib>Singh, Anoushka</creatorcontrib><creatorcontrib>Kopjar, Branko</creatorcontrib><creatorcontrib>Arnold, Paul</creatorcontrib><creatorcontrib>Fehlings, Michael G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tetreault, Lindsay</au><au>Nagoshi, Narihito</au><au>Nakashima, Hiroaki</au><au>Singh, Anoushka</au><au>Kopjar, Branko</au><au>Arnold, Paul</au><au>Fehlings, Michael G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Depression and Bipolar Disorders on Functional and Quality of Life Outcomes in Patients Undergoing Surgery for Degenerative Cervical Myelopathy: Analysis of a Combined Prospective Dataset</atitle><jtitle>Spine (Philadelphia, Pa. 1976)</jtitle><addtitle>Spine (Phila Pa 1976)</addtitle><date>2017-03-15</date><risdate>2017</risdate><volume>42</volume><issue>6</issue><spage>372</spage><epage>378</epage><pages>372-378</pages><issn>0362-2436</issn><eissn>1528-1159</eissn><abstract>STUDY DESIGN.Analysis of a combined prospective dataset.
OBJECTIVE.To compare clinical outcomes in patients with and without preexisting depression or bipolar disorder undergoing surgery for degenerative cervical myelopathy (DCM).
SUMMARY OF BACKGROUND DATA.Psychiatric co-morbidities, including depression, have been associated with worse clinical outcomes following lumbar spine surgery; however, it is unclear whether these psychiatric disorders are also predictive of outcomes in patients undergoing surgery for the treatment of DCM.
METHODS.Four hundred and one patients with symptomatic DCM were enrolled in the prospective AOSpine International or North America study at twelve North American sites. Patients were evaluated preoperatively and at 6-, 12- and 24-months using the modified Japanese Orthopedic Association scale (mJOA), Nurick score, Neck Disability Index (NDI), and Short- Form 36v2 (SF-36) Health Survey. A mixed model analytic approach was used to evaluate differences in outcomes at 24-months between patients with and without psychiatric disorders, while controlling for relevant baseline characteristics and surgical factors.
RESULTS.Ninety-seven patients (24.19%) were diagnosed with preexisting depression or bipolar disorder. There were more females (65.98%) with these psychiatric disorders than males (34.02%) (p < 0.0001). Patients with psychiatric co-morbidities were more likely to have cardiovascular (p = 0.0177), respiratory (p < 0.0001), gastrointestinal (p < 0.0001), rheumatologic (p = 0.0109) and neurologic (p = 0.0309) disorders. At 24-months following surgery, patients in both groups demonstrated significant improvements on the mJOA, Nurick, NDI and SF-36 Physical Component Score (PCS). Patients with depression or bipolar disorder, however, did not exhibit a significant or clinically important change on the SF-36 Mental Component Score (MCS). There were no differences in mJOA and Nurick scores at 24-months between patients in each group. Improvement in NDI, SF-36 PCS and MCS, however, were smaller in patients with depression or bipolar disorder than those without.
CONCLUSIONS.Patients with depression or bipolar disorder have smaller functional and quality of life improvements following surgery compared to patients without psychiatric co-morbidities</abstract><cop>United States</cop><pub>Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>27398891</pmid><doi>10.1097/BRS.0000000000001777</doi><tpages>7</tpages></addata></record> |
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| ispartof | Spine (Philadelphia, Pa. 1976), 2017-03, Vol.42 (6), p.372-378 |
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| source | Journals@Ovid Ovid Autoload; MEDLINE |
| subjects | Adult Aged Aged, 80 and over Bipolar Disorder - complications Cervical Vertebrae - surgery Decompression, Surgical - methods Depression - complications Female Humans Male Middle Aged Prospective Studies Quality of Life Spinal Cord Diseases - surgery Spinal Fusion - adverse effects Spinal Fusion - methods Treatment Outcome |
| title | Impact of Depression and Bipolar Disorders on Functional and Quality of Life Outcomes in Patients Undergoing Surgery for Degenerative Cervical Myelopathy: Analysis of a Combined Prospective Dataset |
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