The Impact of Depression and Pain Catastrophization on Initial Presentation and Treatment Outcomes for Atraumatic Hand Conditions

What Is the Impact of Comorbidities on Self-rated Hand Function in Patients With Symptomatic Trapeziometacarpal Arthritis?

“…Third, without longitudinal data collection, we cannot comment on the effect that depression treatment would have on patient-rated hand function and do not know exactly how depression will impact perceived hand function after treatment of the trapeziometacarpal arthritis. However, based on a prior study by London et al [15], we suspect that depressed patients will respond to treatment of their trapeziometacarpal arthritis to a similar degree as nondepressed patients and thus the final outcome will still indicate greater perceived impairment compared with unaffected patients. Fourth, imperfect interrater agreement determining the Eaton arthritic stage may have resulted in misclassification, which may have biased our data toward a type II error when determining if arthritic stage impacted total MHQ score.…”

“…Furthermore, patients with higher scores for catastrophic thinking, anxiety, posttraumatic stress disorder, and depression on several questionnaires are more likely to be taking opioid pain medications 1 to 2 months after musculoskeletal trauma than patients with lower scores [10]. Depression has also been associated with lower baseline and posttreatment MHQ scores in a general population of patients receiving treatment for atraumatic hand conditions [15]. Collectively, these prior trials suggest that orthopaedic patients with depression report disproportionate pain and functional limitation.…”

“…correlate with radiographic arthritic stage and depressive symptoms has been associated with worse patient-rated hand function [12,15]. This study was conducted to quantify the association of comorbid disease, patient demographics, and arthritic characteristics on patient-rated hand function in patients with symptomatic trapeziometacarpal arthritis compared with asymptomatic control participants.…”

“…Surgical management of the trapeziometacarpal joint can reduce pain and improve function, yet residual disability may remain imperfect despite wellexecuted procedures [29]. Recently published series suggest that sources of pain outside of the thumb and depressive symptoms may contribute substantially to the disability and pain reported by patients with trapeziometacarpal arthritis [2,12,15]. A growing number of studies have examined the effects of psychological comorbidities, including depression, on patient-rated outcome measures for upper extremity musculoskeletal conditions.…”

“…Depression negatively impacts patients' interpretation of pain and illness [13,14,25,26,30]. This provides a strong detrimental influence on patient-rated upper extremity function as assessed by the Disabilities of the Arm, Shoulder, and Hand score (DASH) and the Michigan Hand Questionnaire (MHQ) questionnaire [6,15,27].…”