Depression Following Operative Treatments for Achilles Ruptures and Ankle Fractures

Abstract

Background: The sudden and debilitating nature of lower extremity injuries can trigger mood disturbances, including major depressive disorder. Methods: This prospective study enrolled patients undergoing operative repair of ankle fractures and Achilles ruptures and followed them for 1 year postoperatively. The validated Patient Health Questionnaire (PHQ-9) for depressive symptoms was administered at the preoperative visit and at postoperative weeks 1, 2, 4, 8, 16, 24, 32, 40, and 52. PHQ-9 is scored 0 to 27, with higher values indicating greater depression symptoms. Results: Fifty-eight patients completed 1 year of follow-up. The mean PHQ-9 score was 2.7 (range, 0-20) at the preoperative visit, peaked at postoperative week 1 (4.9; range, 0-16), and reached its low at postoperative week 52 (0.8; range, 0-7). Cumulative incidences of depressive symptoms during the first year following surgery were 51.7% for at least mild depression, 22.4% for at least moderate depression, and 6.9% for severe depression. A history of mental health disorder and the inability to work during the period of postoperative immobilization were independently associated with greater depressive symptoms. Conclusion: The majority of patients undergoing operative treatment of Achilles ruptures and ankle fractures develop postoperative symptoms of mild to moderate depression that normalize after several months. Patients with a history of mental health disorder or who cannot work while immobilized postoperatively are at greatest risk. Level of Evidence: Level II.

Complex interplay of neurodevelopmental disorders (NDDs), fractures, and osteoporosis: a mendelian randomization study

“…Observational studies have historically grappled with the intricate connections among ADHD, ASD, TS, and fractures, as well as osteoporosis. Often, symptoms linked to these NDDs may unintentionally escape attention when investigating fractures [ 46 ]. Our study represents a pioneering effort, constituting the inaugural systematic exploration of the link between childhood NDDs and fractures and osteoporosis through a genetic framework.…”

Complex Interplay of Psychiatry Disorders, Fractures, and Osteoporosis: A Mendelian Randomization Study

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