Association of Anxiety and Depressive Symptoms in Patients with Adhesive Capsulitis

Adhesive capsulitis: current concepts

Adhesive capsulitis, commonly known as frozen shoulder, is a condition characterized by pain and progressive loss of shoulder motion. This condition typically affects individuals between 40 and 60 years of age and can severely impact daily functioning and quality of life. The etiology of adhesive capsulitis is multifactorial, with contributions from systemic conditions such as diabetes and thyroid disorders, as well as idiopathic factors. This review provides an overview of current concepts in the diagnosis and management of adhesive capsulitis, highlighting advancements in both conservative and surgical treatments. Conservative management remains the first-line approach, emphasizing pain relief and restoration of shoulder mobility through physical therapy, analgesics, and corticosteroid injections. Techniques such as the suprascapular nerve block have gained prominence for their effectiveness in reducing pain and facilitating rehabilitation. Recent studies underscore the importance of early intervention and individualized treatment plans tailored to the patient's needs. Surgical intervention, including arthroscopic capsular release, is considered when conservative measures fail to yield satisfactory results. While effective in restoring shoulder function, surgery carries risks and necessitates a comprehensive rehabilitation program to prevent recurrence of stiffness. This review also addresses potential complications associated with both conservative and surgical treatments, and the role of emerging techniques and technologies in improving patient outcomes. The integration of evidence-based practices and personalized care strategies is crucial for optimizing treatment efficacy and enhancing the quality of life for individuals affected by adhesive capsulitis.

Anxiety disorders and adhesive capsulitis: a bidirectional Mendelian randomization study

Background

Previous epidemiological investigations and related research efforts consistently have outlined an observable association between anxiety disorders and adhesive capsulitis (AC). However, the intricate nature of the causal connection between these entities has yet to be fully clarified. Therefore, this investigative study aims to thoroughly examine and delineate the causal interrelationship between anxiety disorders and AC using a bidirectional, two-sample Mendelian randomization (MR) approach.

Methods

To pursue this inquiry, datasets related to anxiety disorders and AC were meticulously obtained from a publicly accessible genomewide association study. Instrumental variables, in the form of single nucleotide polymorphisms, were subsequently identified, undergoing a rigorous screening process that included intensity adjustment and the amelioration of linkage disequilibrium. The primary analytical tool for scrutinizing causal ramifications was the inverse variance weighting (IVW) methodology, complemented by supplementary analytical techniques such as weighted median, MR-Egger, simple mode, and weighted mode. Additionally, evaluations of heterogeneity and pleiotropy were meticulously conducted. Heterogeneity was assessed using Cochran's Q-test in conjunction with the IVW and MR-Egger methods, while pleiotropy was appraised through the MR-Egger intercept and MR-PRESSO analysis methods. A leave-one-out analysis was undertaken to enhance the reliability of our findings. Finally, AC was utilized to infer reverse causality concerning the risk of anxiety disorders.

Results

The random effects IVW analysis results yielded statistical significance (P = 9.362 × 10-6), demonstrating a causal link between anxiety disorders and elevated susceptibility to AC, reflected in an odds ratio of 1.267 (95% confidence interval: 1.141-1.407). Conversely, the inverse MR analysis predominantly produced null findings. Furthermore, sensitivity analyses underscored the robustness of our conclusions.

Conclusion

In summary, our meticulously conducted study unequivocally supports the presence of a causal connection between anxiety disorders and an increased propensity for AC. Unfortunately, the reverse MR analysis failed to provide compelling evidence indicative of a reciprocal genetic causative relationship between AC and anxiety disorders.