How Do Mood Disorders Affect Patients with Rhizarthrosis?

Abstract

Objective Anxiety and/or depression play a major role in how the patient copes with osteoarticular pathology. The aim of the present study is to describe the impact of mood disorders in trapeziometacarpal arthrosis, or osteoarthritis of the first carpometacarpal joint (CMC-1).

Materials and Methods We conducted a descriptive study in patients diagnosed with rhizarthrosis between January 2018 and January 2020. Clinical and demographic factors were collected: age, gender, body mass index (BMI), and diagnosis of anxiety and/or depression; as well as factors specific to the pathology: laterality, degree of CMC-1 osteoarthritis, grip strength, and pinch strength. The scores on the Visual analogue scale for pain (VAS) and the short version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire were also assessed.

Results We reviewed 107 patients (85% of them female) with a mean age of 59.48 ± 7.5 years and a mean BMI of 28.29 Kg/m². In total, 21.5% of the patients were diagnosed with anxiety and/or depression; as for laterality, it was left for 51.4% and right for 48.6% of the patients. According to the Eaton Scale, 54.2% of the patients were grade III, and 45.8%, grade IV. The mean grip strength was of 15.64 kg, and the mean pinch strength was of 3.37 kg. The mean score on the VAS was of 8.28 points, and the mean QuickDASH score was of 65.94 points.

Significant statistical associations were found regarding the diagnosis of anxiety and/or depression and gender (p = 0.023), pinch strength (p = 0.007) and the QuickDASH score (p = 0.004). No statistical relationship was observe regarding other parameters. The significance involving pinch strength disappeared when correcting for gender.

Conclusion The presence of anxiety and/or depression in patients with CMC-1 osteoarthritis, is associated with the female gender and with a worse perception of the functionality on the part of the patients (high QuickDASH scores), but not with pain according to the VAS. This indicates the importance of always considering mood disorders when assessing our patients, sue to their influence in the perception of the osteoarticular disease.

Keywords

CMC-1 osteoarthritis - anxiety - depression - upper limb function - grip strength - pinch strength

Publication History

Received: 29 June 2022

Accepted: 28 September 2022

Article published online:
16 December 2022

• Referencias

• 1 Stubbs B, Aluko Y, Myint PK, Smith TO. Prevalence of depressive symptoms and anxiety in osteoarthritis: a systematic review and meta-analysis. Age Ageing 2016; 45 (02) 228-235
• 2 Wang ST, Ni GX. Depression in Osteoarthritis: Current Understanding. Neuropsychiatr Dis Treat 2022; 18: 375-389
• 3 Agarwal P, Sambamoorthi U. Healthcare expenditures associated with depression among individuals with oateoarthritis: post-regression linear decomposition approach. J Gen Intern Med 2015; 30 (12) 1803-1811
• 4 Veronese N, Stubbs B, Solmi M. et al. Association between lower limb osteoarthritis and incidence of depressive symptoms: data from the osteoarthritis initiative. Age Ageing 2017; 46 (03) 470-476
• 5 Calfee R, Chu J, Sorensen A, Martens E, Elfar J. What is the impact of comorbidities on self-rated hand function in patients with symptomatic trapeziometacarpal arthritis?. Clin Orthop Relat Res 2015; 473 (11) 3477-3483
• 6 Schloemann D, Hammert WC, Liu S, Bernstein DN, Calfee RP. Risk factors for failed nonsurgical treatment resulting in surgery on thumb carpometacarpal arthritis. J Hand Surg Am 2021; 46 (06) 471-477.e1
• 7 Fonseca-Rodrigues D, Rodrigues A, Martins T. et al. Correlation between pain severity and levels of anxiety and depression in osteoarthritis patients: a systematic review and meta-analysis. Rheumatology (Oxford) 2021; 61 (01) 53-75
• 8 Heikkinen J, Honkanen R, Williams L. et al. Depressive disorders, anxiety disorders and subjective mental health in common musculoskeletal diseases: A review. Maturitas 2019; 127: 18-25
• 9 Tan V, Jinks C, Chew-Graham C, Healey EL, Mallen C. The triple whammy anxiety depression and osteoarthritis in long-term conditions. BMC Fam Pract 2015; 16: 163
• 10 Crijns TJ, Bernstein DN, Teunis T. et al. The association between symptoms of depression and office visits in patients with non traumatic upper-extremity illness. J Hand Surg Am 2020; 45 (02) 159.e1-159.e8
• 11 Gandhi R, Zywiel MG, Mahomed NN, Perruccio AV. Depression and the overall burden of painful joints: an examination among individuals undergoing hip and knee replacements for osteoarthritis. Arthritis (Egypt) 2015; 2015: 327161
• 12 Lam NW, Goh HT, Kamaruzzaman SB, Chin AV, Poi PJH, Tan MP. Normative data for hand grip strength and key pinch strength, stratified by age and gender for a multiethnic Asian population. Singapore Med J 2016; 57 (10) 578-584
• 13 Oteo JA, Benavente P, Garzón M. Valores normativos de la fuerza de puño en la población española en edad laboral. Influencia de las variables antropométricas de la mano y el antebrazo. Rev Iberam Cir Mano 2015; 43 (02) 104-110
• 14 Wouters RM, Vranceanu AM, Slijper HP. et al; Hand-Wrist Study Group. Patients with thumb-base osteoarthritis scheduled for surgery have more symptoms, worse psychological profile, and higher expectations than no surgical counterparts: a large cohort analysis. Clin Orthop Relat Res 2019; 477 (12) 2735-2746
• 15 Ottenhoff JSE, Teunis T, Janssen SJ, Mink van der Molen AB, Ring D. Variation in offer of operative treatment to patients with trapeziometacarpal osteoarthritis. J Hand Surg Am 2020; 45 (02) 123-130.e1
• 16 Zdanovec A. Capsule commentary on Agarwal et al., Healthcare Expenditures Associated with Depression among Individuals with Osteoarthritis: Post-Regression Linear Decomposition Approach. J Gen Intern Med 2015; 30 (12) 1851
• 17 Vranceanu AM, Beks RB, Guitton TG, Janssen SJ, Ring D. How do orthopedic surgeons address psychological aspects of illness?. Arch Bone Jt Surg 2017; 5 (01) 2-9