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Affective, anxiety, and substance-related disorders in patients undergoing herniated disc surgery

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Abstract

Purpose

At present only a small number of studies have investigated psychiatric comorbidity in disc surgery patients. Objectives of this study are (1) to examine the prevalence rate of comorbid affective, anxiety, and substance-related disorders in nucleotomy patients in comparison to the German general population and (2) to investigate associations between psychiatric comorbidity and socio-demographic and illness-related characteristics.

Methods

The study refers to 349 consecutive disc surgery patients (response rate 87%) between the age of 18 and 55 years. The final study sample consists of 239 lumbar and 66 cervical nucleotomy patients. Face-to-face interviews were conducted approximately 3.45 days (SD 3.170) after disc surgery, during hospital stay. Psychiatric comorbidity was assessed by means of the Composite International Diagnostic Interview (CIDI-DIA-X). The corresponding data of the German general population were derived from the German National Health Interview and Examination Survey (GHS).

Results

12-Month prevalence rates of any affective, anxiety or substance-related disorders range between 33.7% in cervical and 23.5% in lumbar disc surgery patients. Four-week prevalence rates of any affective, anxiety or substance disorder vary between 13.2% in cervical and 14.0% in lumbar nucleotomy patients. Disc surgery patients suffer more often from affective disorders and illicit substance abuse than the general population. Significant associations were found between psychiatric comorbidity and gender, as well as pain intensity.

Conclusions

Disc surgery patients show a higher risk to suffer from mental disorders than the general population. The assessment of psychiatric distress and the assistance by mental health professionals should be considered during hospital and rehabilitation treatment.

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References

  1. Krämer J (1994) Bandscheibenbedingte Erkrankungen. Thieme, Stuttgart

    Google Scholar 

  2. Kast E, Antoniadis G, Richter H-P (2000) Epidemiologie von Bandscheibenoperationen in der Bundesrepublik Deutschland. Zentralbl Neurochir 61:22–25

    Article  PubMed  CAS  Google Scholar 

  3. Davis H (1994) Increasing rates of cervical and lumbar spine surgery in the United States, 1979–1990. Spine 19:1117–1124

    Article  PubMed  CAS  Google Scholar 

  4. Wang MC, Kreuter W, Wolfla CE, Maiman DJ, Deyo RA (2009) Trends and variations in cervical spine surgery in the United States: medicare beneficiaries, 1992 to 2005. Spine 34:955–961

    Article  PubMed  Google Scholar 

  5. Krämer J (2006) Bandscheibenbedingte Erkrankungen––Ursachen, Diagnose, Behandlung, Vorbeugung, Begutachtung. Georg Thieme Verlag KG, Stuttgart

    Google Scholar 

  6. Zieger M, Schwarz R, Konig HH, Harter M, Riedel-Heller SG (2010) Depression and anxiety in patients undergoing herniated disc surgery: relevant but underresearched––a systematic review. Cen Eur Neurosurg 71:26–34

    Article  PubMed  CAS  Google Scholar 

  7. Taylor RE, Creed F, Hughes D (1997) Relation between psychiatric disorder and abnormal illness behaviour in patients undergoing operations for cervical discectomy. J Neurol Neurosurg Psychiatry 63:169–174

    Article  PubMed  CAS  Google Scholar 

  8. Arpino L, Iavarone A, Parlato C, Moraci A (2004) Prognostic role of depression after lumbar disc surgery. Neurol Sci 25:145–147

    Article  PubMed  CAS  Google Scholar 

  9. Basler HD, Zimmer C (1997) Does disphoric mood really predict the outcome of lumbar spine surgery? Methodological pitfalls in psychological research. Eur J Pain 1:197–205

    Article  PubMed  CAS  Google Scholar 

  10. Graver V, Ljunggren AE, Malt UF, Loeb M, Haaland AK, Magnaes B, Lie H (1995) Can psychological traits predict the outcome of lumbar disc surgery when anamnestic and psychological risk factors are controlled for? Results of a prospective cohort study. J Psychosom Res 39:465–476

    Article  PubMed  CAS  Google Scholar 

  11. Häkkinen A, Ylinen J, Kautiainen H, Airaksinen O, Herno A, Tarvainen U, Kiviranta I (2003) Pain, trunk muscle strength, spine mobility and disability following lumbar disc surgery. J Rehabil Med 35:236–240

    Article  PubMed  Google Scholar 

  12. König HH, Luppa M, Riedel-Heller S (2010) The costs of depression and the cost-effectiveness of treatment. Psychiatr Prax 37:213–215

    Article  PubMed  Google Scholar 

  13. Glaesmer H, Kallert TW, Brahler E, Hofmeister D, Gunzelmann T (2010) The prevalence of depressive symptomatology in the german elderly population and the impact of methodical aspects on the identified prevalence. Psychiatr Prax 37:71–77

    Article  PubMed  Google Scholar 

  14. World Health Organisation (1991) International Classification of Diseases (ICD-10). World Health Organization, Geneva

    Google Scholar 

  15. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders DSM-IV. American Psychiatric Press, Washington, DC

    Google Scholar 

  16. Serrano-Blanco A, Palao DJ, Luciano JV, Pinto-Meza A, Lujan L, Fernandez A, Roura P, Bertsch J, Mercader M, Haro JM (2010) Prevalence of mental disorders in primary care: results from the diagnosis and treatment of mental disorders in primary care study (DASMAP). Soc Psychiatry Psychiatr Epidemiol 45:201–210

    Article  PubMed  Google Scholar 

  17. Wancata J, Meise U (2009) Research instruments in social psychiatry research. Psychiatr Prax 36:368–372

    Article  PubMed  Google Scholar 

  18. Jacobi F, Wittchen H-U, Hölting C, Höfler M, Pfister H, Müller N, Lieb R (2004) Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychol Med 34:597–611

    Article  PubMed  CAS  Google Scholar 

  19. Wittchen H-U, Müller N, Pfister H, Winter S, Schmidtkunz B (1999) Affektive, somatoforme und Angststörungen in Deutschland - Erste Ergebnisse des bundesweiten Zusatzsurveys “Psychische Störungen”. Gesundheitswesen 61:S216–S222

    PubMed  Google Scholar 

  20. Wittchen H-U, Pfister E (1997) Instruktionsmanual zur Durchführung von DIA-X Interviews. Swets & Zeitlinger B.V, Swets Test Services, Frankfurt

    Google Scholar 

  21. Härter M, Hahn D, Baumeister H, Reuter K, Wunsch A, Bengel J (2004) Komorbidität bei Patienten mit muskuloskelettalen und kardiovaskulären Erkrankungen - Prävalenzen, Diagnosen und Konsequenzen für die Rehabilitation. J Public Health 12:162–167

    Article  Google Scholar 

  22. Härter M, Reuter K, Gross-Hardt M, Bengel J (2001) Screening for anxiety, depressive and somatoform disorders in rehabilitation––validity of HADS and GHQ-12 in patients with musculoskeletal disease. Disabil Rehabil 23:737–744

    Article  PubMed  Google Scholar 

  23. Härter M, Reuter K, Weisser B, Schretzmann B, Aschenbrenner B, Bengel J (2002) A descriptive study of psychiatric disorders and psychosocial burden in rehabilitation patients with musculoskeletal diseases. Arch Phys Med Rehabil 83:461–468

    Article  PubMed  Google Scholar 

  24. Potter JS, Prather K, Kropp F, Byrne M, Sullivan CR, Mohamedi N, Copersino ML, Weiss RD (2010) A method to diagnose opioid dependence resulting from heroin versus prescription opioids using the Composite International Diagnostic Interview. Contemp Clin Trials 31:185–188

    Article  PubMed  Google Scholar 

  25. Wilson EB (1927) Probable inference, the law of succession, and statistical inference. J Am Stat Assoc 22:209–212

    Article  Google Scholar 

  26. Härter M, Woll S, Reuter K, Wunsch A, Bengel J (2004) Recognition of psychiatric disorders in musculoskeletal and cardiovasular rehabilitation patients. Arch Phys Med Rehabil 85:1192–1197

    Article  PubMed  Google Scholar 

  27. Polatin PB, Kinney RK, Gatchel RJ, Lillo E, Mayer TG (1993) Psychiatric illness and chronic low-back pain. The mind and the spine––which goes first? Spine 18:66–71

    Article  PubMed  CAS  Google Scholar 

  28. Nickinson RS, Board TN, Kay PR (2009) Post-operative anxiety and depression levels in orthopaedic surgery: a study of 56 patients undergoing hip or knee arthroplasty. J Eval Clin Pract 15:307–310

    Article  PubMed  Google Scholar 

  29. Sullivan M, Tanzer M, Stanish W, Fallaha M, Keefe FJ, Simmonds M, Dunbar M (2009) Psychological determinants of problematic outcomes following total knee arthroplasty. Pain 143:123–129

    Article  PubMed  Google Scholar 

  30. Brander V, Gondek S, Martin E, Stulberg SD (2007) Pain and depression influence outcome 5 years after knee replacement surgery. Clin Orthop Relat Res 464:21–26

    PubMed  Google Scholar 

  31. Häkkinen A, Ylinen J, Kautiainen H, Airaksinen O, Herno A, Kiviranta I (2003) Does the outcome 2 months after lumbar disc surgery predict the outcome 12 months later. Disabil Rehabil 25:968–972

    Article  PubMed  Google Scholar 

  32. Penta M, Fraser RD (1997) Anterior lumbar interbody fusion. A minimum 10-year follow-up. Spine 22:2429–2434

    Article  PubMed  CAS  Google Scholar 

  33. Junge A, Dvorak J, Ahrens S (1995) Predictors of bad and good outcomes of lumbar disc surgery. A prospective clinical study with recommendations for screening to avoid bad outcomes. Spine 20:460–468

    Article  PubMed  CAS  Google Scholar 

  34. Jarvik JG, Hollingworth W, Heagerty PJ, Haynor DR, Boyko EJ, Deyo RA (2005) Three-year incedence of low back pain in an initially asymptomatic cohort. Clinical and imaging risk factors. Spine 30:1541–1548

    Article  PubMed  Google Scholar 

  35. Beesdo K, Jacobi F, Hoyer J, Low NC, Hofler M, Wittchen HU (2010) Pain associated with specific anxiety and depressive disorders in a nationally representative population sample. Soc Psychiatry Psychiatr Epidemiol 45:89–104

    Article  PubMed  Google Scholar 

  36. Schneider S, Mohnen SM, Schiltenwolf M, Rau C (2007) Comorbidity of low back pain: representative outcomes of a national health study in the Federal Republic of Germany. Eur J Pain 11:387–397

    Article  PubMed  Google Scholar 

  37. Miller S, Lo C, Gagliese L, Hales S, Rydall A, Zimmermann C, Li M, Rodin G (2010) Patterns of depression in cancer patients: an indirect test of gender-specific vulnerabilities to depression. Soc Psychiatry Psychiatr Epidemiol (Epub ahead of print)

  38. Baumeister H, Harter M (2007) Prevalence of mental disorders based on general population surveys. Soc Psychiatry Psychiatr Epidemiol 42:537–546

    Article  PubMed  Google Scholar 

  39. Mannion AF, Elfering A (2006) Predictors of surgical outcome and their assessment. Eur Spine J 15:S93–S108

    Article  PubMed  Google Scholar 

  40. Trief PM, Grant W, Fredrickson B (2000) A prospective study of psychological predictors of lumbar surgery outcome. Spine 25:2616–2621

    Article  PubMed  CAS  Google Scholar 

  41. Bringmann H, Singer S, Hockel M, Stolzenburg JU, Krauss O, Schwarz R (2008) Longitudinal analysis of psychiatric morbidity in cancer patients. Onkologie 31:343–344

    Article  PubMed  Google Scholar 

  42. Vahdaninia M, Omidvari S, Montazeri A (2010) What do predict anxiety and depression in breast cancer patients? A follow-up study. Soc Psychiatry Psychiatr Epidemiol 45:355–361

    Article  PubMed  Google Scholar 

  43. Kühn-Mengel H (2008) Ausbau der Patientenberatung: bei psychischen Erkrankungen von besonderer Bedeutung. Psychiatr Prax 35:107

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This publication has been supported by the Department of Neurosurgery of the Klinikum St. Georg gGmbH Leipzig, by the Department of Neurosurgery of the University of Leipzig and by the Department of Neurosurgery of the Berufsgenossenschaftliche Kliniken Bergmannstrost Halle (Saale). This publication was funded by the Deutsche Rentenversicherung Bund (Project: Psychiatric comorbidity and early retirement in patients with somatic diseases. Reference number: 8011-106-31/31.81) and has received ethics committee approval.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Institute for Social Medicine and Occupational Health, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany

    Margrit Zieger, Melanie Luppa & Steffi G. Riedel-Heller

  2. Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany

    Herbert Matschinger

  3. Department of Neurosurgery, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale), Germany

    Hans J. Meisel

  4. Department of Neurosurgery, Klinikum St. Georg gGmbH, Leipzig, Germany

    Lutz Günther

  5. Department of Neurosurgery, University of Leipzig, Leipzig, Germany

    Jürgen Meixensberger

  6. MEDICA-Klinik, Leipzig, Germany

    René Toussaint

  7. Center for Public Mental Health, Gösing am Wagram, Austria

    Matthias C. Angermeyer

  8. Department of Public Health, University of Cagliary, Cagliary, Italy

    Matthias C. Angermeyer

  9. Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Hans-Helmut König

Authors
  1. Margrit Zieger
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  2. Melanie Luppa
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  4. Hans J. Meisel
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  8. Matthias C. Angermeyer
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  9. Hans-Helmut König
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  10. Steffi G. Riedel-Heller
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Correspondence to Margrit Zieger.

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Zieger, M., Luppa, M., Matschinger, H. et al. Affective, anxiety, and substance-related disorders in patients undergoing herniated disc surgery. Soc Psychiatry Psychiatr Epidemiol 46, 1181–1190 (2011). https://doi.org/10.1007/s00127-010-0283-2

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  • DOI: https://doi.org/10.1007/s00127-010-0283-2

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