ArticleRegional anesthesia and pain medicine2018
Changes in Anxiety and Depression Are Mediated by Changes in Pain Severity in Patients Undergoing Lower-Extremity Total Joint Arthroplasty.
Article in Regional anesthesia and pain medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.
- Systematic review: preoperative psychological factors and total hip arthroplasty outcomes.Journal of orthopaedic surgery and research · 2022Pooled it
- A prospective study comparing sleep quality using Pittsburgh Sleep Quality Index at 8 weeks after robotic-assisted versus conventional total knee arthroplasty: a single-center study.Journal of robotic surgery · 2025Trial
- The efficacy and safety of patient-controlled intravenous analgesia with esketamine after total hip arthroplasty: a randomized controlled trial.BMC anesthesiology · 2025Trial
- Associations among state-trait anxiety, resilience, and health-related quality of life in patients with dentofacial deformities: a prospective study.BMC oral health · 2026Article
- The impact of total knee arthroplasty on functional outcomes and mental health: A prospective study.Journal of experimental orthopaedics · 2025Article
- Impact of preoperative factors on clinical outcomes after total hip arthroplasty.World journal of orthopedics · 2025Article
- Impact of postoperative depression and immune-inflammatory biomarkers on the prognosis of patients with esophageal cancer receiving minimally invasive esophagectomy: a retrospective cohort study based on a Chinese population.Frontiers in immunology · 2025Article
- Deciphering nociplastic pain: clinical features, risk factors and potential mechanisms.Nature reviews. Neurology · 2024Review
- Effect of Rectus Sheath Block on Postoperative Quality of Recovery After Transabdominal Midline Gynecological Surgery: A Randomized Controlled Trial.Journal of pain research · 2024Article
- Depression risk in chronic tonsillitis patients underwent tonsillectomy: a global federated health network analysis.International journal of medical sciences · 2024Article
- Clinical use of autologous adipose-derived stromal vascular fraction cell injections for hip osteoarthritis.Regenerative therapy · 2023Article
- Effect of an educational video about ERAS on reducing preoperative anxiety and promoting recovery.Heliyon · 2023Article
- Impact of multimodal analgesia on postoperative anxiety and depression following total knee arthroplasty.Journal of orthopaedic surgery and research · 2023Article
- Comparison of postoperative pain, anxiety, and sleep quality in robotic-assisted and manual total knee replacement surgery.Journal of robotic surgery · 2023Observational
- Prospective cohort study on the trajectory and association of perioperative anxiety and postoperative opioid-related outcomes.Regional anesthesia and pain medicine · 2022Article
- Does resilience predict hospital length of stay after total knee arthroplasty? A prospective observational cohort study.Arthroplasty (London, England) · 2022Article
- Alterations of monoamine neurotransmitters, HPA-axis hormones, and inflammation cytokines in reserpine-induced hyperalgesia and depression comorbidity rat model.BMC psychiatry · 2022Article
- Depression and Anxiety Screening Identifies Patients That may Benefit From Treatment Regardless of Existing Diagnoses.Arthroplasty today · 2022Article
- [Preoperative management in fast-track arthroplasty].Der Orthopade · 2022Review
- The duration of chronic low back pain is associated with acute postoperative pain intensity in lumbar fusion surgery: a prospective observational study.BMC anesthesiology · 2022Observational
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDepression and anxiety are common comorbidities in chronic pain including osteoarthritis patients undergoing total joint arthroplasty (TJA). What is not clear is whether psychiatric comorbidity precedes the manifestation of painful states or represents a reaction to living with chronic pain and associated functional impairment. The objective of this research was to explore whether decreases in depressive and anxiety symptoms after lower-extremity TJA could be due to postsurgical reductions in pain.
methodsWe conducted a secondary analysis of data from 1448 TJA patients enrolled in the Analgesics Outcome Study. Patients completed measures of pain intensity, functional status, and depressive and anxiety symptoms preoperatively and at 3 and 6 months postoperatively. Data were analyzed using a structural equation modeling approach.
resultsWe found that improvement in pain and physical function from baseline to 6 months postoperatively was associated with improvement in depression and anxiety symptoms. We also found that a change in overall body pain at 3 months after surgery significantly mediated changes in both the depression and anxiety scores at 6 months after surgery even when controlling for age, sex, baseline body pain, education, opioid use, and type of surgery.
conclusionsPresurgical affective symptoms not only have an effect on change in postsurgical pain, whereby lower preoperative scores on depression and anxiety were associated with lower postsurgical pain, but also postsurgical decreases in pain were associated with lower levels of depression and anxiety after surgery. Taking these points into consideration may prove useful in working toward better outcomes for TJA.
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