Prevalence of diagnosable depression in patients awaiting orthopaedic specialist consultation: a cross-sectional analysis

Rhiannon K Patten; Alev Asilioglu; Itamar Levinger; Alexander Tacey; Michaela Pascoe; Phong Tran; Michael J McKenna; Catherine M Said; Natali Coric; Mary De Gori; Rebecca Lane; Vasso Apostolopoulos; Mary N Woessner; Alexandra Parker

doi:10.1186/s12891-023-06688-0

Prevalence of diagnosable depression in patients awaiting orthopaedic specialist consultation: a cross-sectional analysis

BMC Musculoskelet Disord. 2023 Jul 22;24(1):599. doi: 10.1186/s12891-023-06688-0.

Authors

Rhiannon K Patten^{1

2}, Alev Asilioglu¹, Itamar Levinger^{1

3}, Alexander Tacey^{1

2}, Michaela Pascoe¹, Phong Tran^{1

2

3}, Michael J McKenna¹, Catherine M Said^{3

4

5}, Natali Coric², Mary De Gori⁵, Rebecca Lane¹, Vasso Apostolopoulos^{1

3}, Mary N Woessner⁶, Alexandra Parker¹

Affiliations

¹ Institute for Health and Sport, Victoria University, Melbourne, Australia.
² Department of Orthopaedic Surgery, Western Health, Melbourne, Australia.
³ Australian Institute for Musculoskeletal Science (AIMSS), Victoria University, University of Melbourne and Western Health, Melbourne, Australia.
⁴ Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia.
⁵ Physiotherapy, Western Health, Melbourne, Australia.
⁶ Institute for Health and Sport, Victoria University, Melbourne, Australia. mary.woessner@vu.edu.au.

Abstract

Background: Musculoskeletal conditions, including osteoarthritis (OA), are a leading cause of disability and chronic pain, and are associated with high rates of comorbid depression. However, signs of depression are often masked by pain. The aim of this study was to determine the prevalence and severity of depression and pain in individuals awaiting specialist orthopaedic consultation. A secondary objective was to determine the relationship between pain and depression, irrespective of demographic factors and clinical diagnosis.

Methods: Cross-sectional analysis of individuals awaiting orthopaedic consultation at a public hospital in Melbourne, Australia. Relevant data were extracted from medical records and questionnaires. Descriptive statistics were used to summarise participant characteristics. The patient health questionnaire (PHQ-9) was used to assess depression and a numerical rating scale (NRS) was used to assess pain severity. Multiple linear regression analyses were used to establish the relationship between pain and depression.

Results: Nine hundred and eighty-six adults (mean ± standard deviation, age = 54.1 ± 15.7 years, 53.2% women) participated in the study. OA was present in 56% of the population and 34% of the entire population had moderate depression or greater, 19% of which met the criteria for major depressive disorder. Moderate-to-severe pain was present in 79% of individuals with OA and 55% of individuals with other musculoskeletal complaints. Pain was significantly associated with depression scores (β = 0.84, adjusted R² = 0.13, P < 0.001), and this relationship remained significant after accounting for gender, age, education and employment status, OA status, number of joints affected and waiting time (β = 0.91, adjusted R² = 0.19, P < 0.001).

Conclusions: Depression affects one-third of individuals on an orthopaedic waitlist. A strong link between pain and depression in patients awaiting specialist orthopaedic consultation exists, indicating a need for an integrated approach in addressing pain management and depression to manage this complex and comorbid presentation.

Keywords: Depression; Musculoskeletal; Orthopaedic; Osteoarthritis; Pain; Specialist care; Waitlist.

MeSH terms

Adult
Aged
Chronic Pain*
Cross-Sectional Studies
Depression / diagnosis
Depression / epidemiology
Depressive Disorder, Major*
Female
Humans
Male
Middle Aged
Orthopedics*
Prevalence

Abstract

MeSH terms

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