The influence of different THA surgical approaches on Patient's early postoperative anxiety and depression

INTRODUCTION

Total hip arthroplasty (THA) is generally considered to be one of the most successful orthopedic surgical procedures. However, no research has been conducted on the postoperative mental health of patients who underwent different approaches of THA. This paper seeks to compare the differences among three THA approaches: the normal lateral approach (NLA), the direct anterior approach (DAA) and the orthopädische chirurgie münchen (OCM) regarding their influence on patients' postoperative anxiety and depression.

METHOD

A total of 95 THA patients were recruited for this study. All patients' preoperative information including results of Harris, SF-36 and Visual Analogue Scale (VAS) was carefully evaluated. Surgery-related data as well as five-day postoperative data were also collected. Three months after the surgery, a telephone follow-up was conducted to further evaluate patients' HADS and SF-36 results.

RESULT

In the three-month postoperative evaluation of anxiety and depression, the NLA group scored significantly higher than both the DAA group and the OCM group, which was found relevant to the patient's incision length and five-day postoperative VAS results. A correlation between anxiety scores and the days of postoperative hospitalization was also noticed. Further analysis of patients' psychological state based on the SF-36 results revealed considerable differences in viability (VT) and social function (SF) between the NLA group and the OCM group. Other surgery-related data and postoperative data all demonstrated better results of the DAA group and the OCM group compared to the NLA group.

CONCLUSION

Among the three different surgical approaches of THA, DAA and OCM compared with NLA are found to ease patients' postoperative anxiety and depression.

LEVEL OF EVIDENCE

III.

Symptoms of post-traumatic stress disorder (PTSD) in next of kin during suspension of ICU visits during the COVID-19 pandemic: a prospective observational study

BACKGROUND

During the COVID-19 pandemic, suspension of visits by next of kin to patients in intensive care units (ICU), to prevent spread of the SARS-CoV-2 virus, has been a common practice. This could impede established family-centered care and may affect the mental health of the next of kin. The aim of this study was to explore symptoms of post-traumatic stress syndrome (PTSD) in the next of kin of ICU patients.

METHODS

In this prospective observational single-center study, next of kin of ICU patients were interviewed by telephone, using the Impact of Event Scale-Revised (IES-R), to assess symptoms of acute stress disorder during the ICU stay and PTSD symptoms at 3 months after the ICU stay. The primary outcome was the prevalence of severe PTSD symptoms (IES-R score ≥ 33) at 3 months. The secondary outcomes comprised the IES-R scores during the ICU stay, at 3 months, and the prevalence of severe symptoms of acute stress disorder during ICU stay. An inductive content analysis was performed of the next of kin's comments regarding satisfaction with patient care and the information they were given.

RESULTS

Of the 411 ICU patients admitted during the study period, 62 patients were included together with their next of kin. An IES-R score > 33 was observed in 90.3% (56/62) of next of kin during the ICU stay and in 69.4% (43/62) 3 months later. The median IES-R score was 49 (IQR 40-61) during the ICU stay and 41 (IQR 30-55) at 3 months. The inductive content analysis showed that communication/information (55%), support (40%), distressing emotions (32%), and suspension of ICU visits (24%) were mentioned as relevant aspects by the next of kin.

CONCLUSIONS

During the suspension of ICU visits in the COVID-19 pandemic, high prevalence and severity of both symptoms of acute stress disorder during the ICU stay and PTSD symptoms 3 months later were observed in the next of kin of ICU patients.

Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: A population-based survey

BACKGROUND AND AIM

Functional gastrointestinal disorders are a group of stress-sensitive gut-brain disorders. The COVID-19 outbreak has caused immense stress and anxiety among the general public. Strict measures to counter COVID-19 emergency, including physical distancing, have also taken a toll on physical and mental health. We investigated the impact of the COVID-19 pandemic on the gastrointestinal and psychological symptoms of functional dyspepsia (FD) and irritable bowel syndrome (IBS).

METHODS

An online survey was conducted in Japan for a group of randomly assigned panelists from May 26 to 27, 2020. Each respondent answered a questionnaire on stress, physical distancing, and worries about COVID-19. Gastrointestinal symptoms were assessed to diagnose FD and IBS (Rome III), and psychological symptoms were assessed using the Hospital Anxiety and Depression Scale.

RESULTS

A total of 5157 subjects were finally enrolled, with FD in 8.5%, IBS in 16.6%, and FD-IBS overlap in 4.0%. For both gastrointestinal and psychological symptoms, respondents with FD-IBS overlap showed the worst scores, followed by IBS-alone, then FD-alone respondents. During the COVID-19 pandemic, 11.9% of respondents reported deterioration and 2.8% reported improvement of gastrointestinal symptoms. FD-IBS overlap, psychological disease comorbidity, and stress at work/school were significantly associated with symptom deterioration. Younger age, commuting by public transport, and work/study from home were associated with symptom improvement.

CONCLUSIONS

The COVID-19 pandemic negatively affected FD/IBS subjects, with respondents showing FD-IBS overlap syndrome as the most important independent factor associated with deterioration in gastrointestinal symptoms. Physicians need to take extra care of FD/IBS patients in the post-COVID period.

Impacts of the COVID-19 pandemic on functional dyspepsia and irritable bowel syndrome: A population-based survey

BACKGROUND AND AIM

Functional gastrointestinal disorders are a group of stress-sensitive gut-brain disorders. The COVID-19 outbreak has caused immense stress and anxiety among the general public. Strict measures to counter COVID-19 emergency, including physical distancing, have also taken a toll on physical and mental health. We investigated the impact of the COVID-19 pandemic on the gastrointestinal and psychological symptoms of functional dyspepsia (FD) and irritable bowel syndrome (IBS).

METHODS

An online survey was conducted in Japan for a group of randomly assigned panelists from May 26 to 27, 2020. Each respondent answered a questionnaire on stress, physical distancing, and worries about COVID-19. Gastrointestinal symptoms were assessed to diagnose FD and IBS (Rome III), and psychological symptoms were assessed using the Hospital Anxiety and Depression Scale.

RESULTS

A total of 5157 subjects were finally enrolled, with FD in 8.5%, IBS in 16.6%, and FD-IBS overlap in 4.0%. For both gastrointestinal and psychological symptoms, respondents with FD-IBS overlap showed the worst scores, followed by IBS-alone, then FD-alone respondents. During the COVID-19 pandemic, 11.9% of respondents reported deterioration and 2.8% reported improvement of gastrointestinal symptoms. FD-IBS overlap, psychological disease comorbidity, and stress at work/school were significantly associated with symptom deterioration. Younger age, commuting by public transport, and work/study from home were associated with symptom improvement.

CONCLUSIONS

The COVID-19 pandemic negatively affected FD/IBS subjects, with respondents showing FD-IBS overlap syndrome as the most important independent factor associated with deterioration in gastrointestinal symptoms. Physicians need to take extra care of FD/IBS patients in the post-COVID period.

Pacemaker implantation in patients with major depression, should it be of concern? A case report and literature review

Background

Psychological adaptation after cardiac pacemaker implantation is a challenge for patients with mental illness.

Case presentation

Here we report a self-harming patient with a psychiatric disorder. A 73-year-old female patient with 16-year coronary heart disease and a 4-year depression was admitted to our hospital for a coma. Two months earlier, the local hospital confirmed that the patient had a second-degree sinoatrial (SA) block (type 2) as well as basal septal hypertrophy with the left ventricular outflow obstruction. Therefore, metoprolol sustained-release tablets 95 mg QD and diltiazem sustained-release tablets 90 mg QD was given as treatment after a pacemaker was implanted. However, the patient had continued complaining about discomfort due to the pacemaker implanted after being discharged from the hospital. Two months later, she attempted to commit suicide by removing her pacemaker and taking 80 sleeping pills. After a series of treatments, the patient improved and was discharged without a pacemaker re-implantation. With continued anti-depression treatment and strengthen family supervision, the patient’s condition is stable now.

Conclusions

A suicide attempt by intentionally removing the permanent pacemaker system was rarely reported. In bradycardia patients with a history of psychological or psychiatric disease, careful evaluation should be done before and after implantation of the pacemaker.

Behavioral analysis of mental and psychological abnormalities and their significance in rats with functional constipation

AIM

To observe, compare, and analyze the behavior of rats with functional constipation and evaluate the psycho-logical basis for their behavior.

METHODS

Sixty SD rats with a male-female ratio of 1:1 were randomly and equally divided into three groups: a severe constipation group, a mild constipation group, and a control group. Constipation was induced in rats by intragastric administration of compound diphenoxylate. The difference between the severe constipation group and mild constipation group was the severity of constipate symptoms, which was caused by the difference in the dose of compound diphenoxylate used. The weight and defecation of each group were recorded after constipation was modeled successfully. Behaviors of all the groups were assessed by the empty bottle stress test (aggression, modification, and exploration), elevated plus-maze test (anxiety), and sucrose preference test (depression). The data obtained were then statistically analyzed.

RESULTS

In the empty bottle stress test, neither aggressive behavior nor modified behavior in both mild and severe constipation rats had a significant change compared with the control group; however, exploratory behavior showed a statistical change which seemed to be related with the severity of symptoms. No significant difference was observed among all groups in the elevated plus-maze test. As to the sucrose preference test, the sugar water consumption and preference degree of rats with severe constipation were significantly lower than those of the control group, while no difference was observed between the mild constipation group and control group.

CONCLUSION

The severity of constipate symptoms might be related to the dosage of modeling drugs. Also, the severity of symptoms is positively correlated with the behavioral abnormality. However, the behavioral performance of constipation rats is complicated, and the psychological state is generally inclined to depression.

Spouses of male psychiatric patients are more prone to intimate partner violence

Intimate partner violence (IPV) is a great public health concern. Most studies have evaluated different risk factors of IPV in general population, but few have evaluated the perpetration of IPV by subjects with psychological disease. We evaluated the prevalence of IPV among spouses of men with psychiatric disease. In this descriptive study, we questioned 119 women whose husbands were in-patient or out-patients of psychology clinic. A validated questionnaire was used for evaluation IPV and its different subtypes. All women reported to encounter some kind of IPV in some periods. Women reported emotional abuse in 100%, physical abuse in 99.2% and sexual abuse in 81.5%. None of the patients were eager to tell anyone about being victim of IPV due to religious beliefs, society culture and believing in their marital status and trying to keep their marriage. IPV is higher among families with men having psychological disease. Policy makers and clinicians should predominantly target these families. Also, empowering women may reduce the risk of intimate partner violence.