Depression, pain and physical function in patients with osteoarthritis of the knee: implications for interprofessional care
Abstract
Background and purpose: Depression has been found to be associated with pain and poor physical function in patients with knee osteoarthritis though it is not sufficiently documented in Nigeria. This study was aimed at investigating the relationship among pain, depression and physical function in patients with knee osteoarthritis in Ibadan. Methods: Eighty individuals diagnosed with knee osteoarthritis were screened for depression using the mood/ depression assessment questionnaire. Depression, physical function and pain were assessed by Becks Depression Inventory, Ibadan Knee Hip Osteoarthritis Outcome Measure and Modified Visual Analogue Scale respectively. Data were analyzed using Pearson’s correlation test and linear regression (alpha level set at 0.05).
Results: Screening for depression was positive in 28.8% of patients aged 62.69 ± 5.96 years. There were significant correlations between physical function and each of pain intensity (r=-0.659) and depression (r = - 0.660) and between pain intensity and depression (r= 0.611). Negative linear relationship exist between physical function and each of pain (R2=0.434), depression (R2=0.436). A positive linear relationship exists between pain intensity and depression (R2=0.374).
Conclusion: About a quarter of patients with knee osteoarthritis had depression. Individuals with knee osteoarthritis who had higher levels of pain were more depressed and had lower level of physical function.References
Abramson, S., Caplan, A.I., Goldberg, V., Gould, H.J., Hochberg, M.C., Joshi, G.P., Kauffman, J.I., Miller, M.D., Putukian, M., Rosen, J.E., Saddemi, S.R., Schaible, H.G., Schrank, L.P.,(2011). Management of Osteoarthritis Knee Pain- The State of the Science: http://www.medscape.com/education. Accessed on 19/9/2013; 07:52p.m
Aghdam A.R.M., Kolahi S., Hasankhani H., Behshid M., Varmaziar Z. (2013). The
relationship between pain and physical function in adults with Knee Osteoarthritis, International Research Journal of Applied and Basic Sciences, 4 (5), 1102-1106
Akinpelu, A.O., Alonge, T.O., Odole, A.C., Adekanla, B.A., (2009). Prevalence and
Pattern of Sympthomatic Knee Osteoarthritis in Nigeria: A Community based
Study, The Internet Journal of Allied Health Sciences and Practice, 7:1-2
Akinpelu, A.O., Odole, A.C., Raheem, S., (2011). Minimal clinically Important
difference of Ibadan Knee/Hip Osteoarthritis Measure- A Cross sectional study, Journal of Physical Therapy, 3(2), 52-60
Akinpelu, A.O., Odole, A.C., Adegoke, B.O.A., Adeniyi, A.F., (2007). Development
and initial Validation of Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM), South African Journal of Physiotherapy, 63, 3-8.
Alexopoulos, G.S., (2005). Depression in the elderly. Lancet, 365,1961-1970.
Atowoju, A.A. (2013). Effects of a Twelve-Week Arm Ergometry Training on
Selected Health Indices of Lower Limb Paralytic Poliomyelitis Survivors, A Ph.D. Project work (on-going), Department of Physiotherapy, College of Medicine, University of Ibadan, Nigeria
Bair, M.J., Wu, J., Damush, T.M., Sutherland, J.M., Kroenke, K. (2008). Association
of depression and anxiety alone and in combination with musculoskeletal pain in primary care patients. Psychosomatic Medicine, 70, 890-897.
Beck, A. T., Steer, R. A., Brown, G. K. (1996a). Manual for the Beck Depression
Inventory -II. - San Antonio: Psychological Corporation.
Beck, A.T., Steer, R.A., Ball, R., Ranieri, W (1996b). Comparison of Beck
Depression Inventories -1A and 11 in psychiatric outpatients. Journal of Personality Assessment, 67 (3), 588–597. doi:10.1207/s15327752jpa6703_13
Creamer, P., Lethubridge-Cejku, M., Hochberg, M.C., (2000). Factors associated with
functional impairment in symptomatic knee osteoarthritis. Rheumatology 39: 490-496
Coulehan, J.L., Schulberg, H.C., Block, M.R., Madonia, M.J., Rodrigues, E. (1997).
Treating depressed primary care patients improves their physical, mental, and social functioning. Archives of Internal Medicine, 157,1113-1120
Kroenke, K., Shen, J., Oxman, T.E., Williams, J.W Jr., Dietrich, A.J., (2008). Impact
of pain on the outcomes of depression treatment: results from the RESPECT trial. Pain, 134, 209-215.
Kim, K.W., Han, J.W., Cho, H.J., Chang, C.B., Park, J.H., Lee, J.J., Lee, S.B.,
Seong,S.C., and Kim, T.K., (2011). Association Between Comorbid Depression and Osteoarthritis Symptom Severity in Patients with Knee Osteoarthritis. The Journal of bone & Joint Surgery. .93-A (6), 556-563
Leite, A.A., Costa, A.J.G., Matheos de Lima, B., Padilha, A.V L., Cavalcanti de
Albuquerque, E., Marques, C.D.L. (2011). Comorbidities in patients with osteoarthritis: frequency and impact on pain and physical function. Revista Brasileira Rheumatologia 51(2), 113-123
Lozada, C.J., (2012). Osteoarthritis: http://www.medscape.com/reference. accessed
on 26/8/2013, 11:00p.m
Leeuw, M., Goosens, M.E.J.B., Linton, S.J., Cromberz, G., Boersma, K., Vlaeyen,
J.W.S (2005). The Fear-avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence. Journal of Behavioral Medicine, 30(1), 77-94
Lin, E.H.B., (2008). Depression and Arthritis: The American Journal of Medicine, 121 (11), Supplement 2, S16-S19
Lin, E.H.B., Katon W., Korff, M.V., Tang, L., Williams, J.W., Kroenke,K., Hunkeler,
E., Harpole, L., Hegel, K., Arean, P., Hoffing, M., Penna, R.D., Langston, C., Unützer, J., (2003). Effect of Improving Depression Care on Pain and Functional Outcomes Among Older Adults With Arthritis: A Randomized Controlled Trial: The Journal of American Medical Association, 290(18), 2428-2429.
Maly, M.R., Costigan, P.A., Olney, S.J. (2006). Determinants of self-report outcome
measures in people with knee osteoarthritis. Archives of Physical Medicine and Rehabilitation, 87(1), 96-104.
Merle-Vincent, F., Vignon, E., Brandt, K., Piperno, M., Coury-Lucas, F., Conrozier,
T.P., Mathieu, P., Hellio Le Graverand, M.P (2007). Superiority of the Lyon schuss view over the standing anteroposterior view for detecting joint space narrowing, especially in the lateral tibiofemoral compartment, in early knee osteoarthritis. Annals of Rheumatic Diseases, 66, 747–753. doi: 10.1136/ard.2006.056481
National Institute of Mental Health (NIMH) (2009).Depression Available at:
http://www.nimh.nih.gov/health/topics/depression/index. shtml. Accessed August 11, 2013.
Neogi, T., Zhangi, Y., (2013): Epidemiology of Osteoarthritis. Rheumatic Diseases
Clinics of North America, 39(1), 1-19
Odole, A.C., Akinpelu, A.O., (2009): Translation and Alternate Forms Reliability of
the Visual Analogue Scale in the Three Major Nigerian languages. The Internet Journal of Allied Health Sciences and Practice, 7, 1-4.
Odole, A.C., Akinpelu, A.O., Bamgboye, E.A., (2006). Validity and internal
consistency of a Yoruba Version of the Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM). African Journal of Medicine and Medical Science, 35, 349-357.
Ogunlade, S.O, Alonge, T.O, Omololu, A.B, Adekolujo, O.S., (2005). Clinical
Spectrum of Large Joint Osteoarthritis in Ibadan, Nigeria. European Journal of Scientific Research, 11(2), 116-122
Ozcetin, A., Ataoglu, S., KocerI, E., Yazycy, S., Yildiz, O., Ataoglu A; Ycmeli, C.,
(2007). Effects of depression and anxiety on quality of life of patients with rheumatoid arthritis, knee osteoarthritis and fibromyalgia syndrome. West Indian Medical Journal, 56 (2), 122
Possley, D., Budiman-Mak, O'Connell, S., Jelinek, C., Collins,E.G. (2009),
Relationship between depression and functional measures in overweight and obese persons with osteoarthritis of the knee. Journal of Rehabilitation Research & Development, 46 (9), 1091- 1098
Price, D.D., McGrath, P.A., Rafii, A., Buckingham, B. (1983). The validation of
visual analogue scale as ratio scale measures for chronic and experimental. Pain, 17, 45-46
Rosemann, T., Backenstrass, M., Joest, K., Rosemann, A., Szecsenyi, J., Laux, G.,
(2007), Predictors of depression in a sample of 1,021 primary care patients with osteoarthritis. Arthritis and Rheumatism, 57, 415-422.
Salaffi, F., Cavalieri, F., Nolli, M., Ferraccioli, G.F. (1991). Analysis of disability in
knee Osteoarthritis: Relationship with age and psychological variables but not with radiographic score. Journal of Rheumatology, 18, 1581-1586
Scopaz, A.K., Sara R.P., Wisniewski, S., Fitzgerald, G.K., (2009). Relationships of
Fear, Anxiety, and Depression with Physical Function in Patients with Knee Osteoarthritis. Archives of Physical Medicine and Rehabilitation, 90, 1866-1873
Snijders, A.H., Robertson, M.M., Orth, M. (2006). Beck Depression Inventory is a
Useful Screening tool for Major Depressive Disorder in Gilles de la Tourette Syndrome. Journal of Neurology, Neurosurgery and Psychiatry, 77, 787–789. doi: 10.1136/jnnp.2005.084657
Weinberger, I.M., Sirey, J.A., Bruce, M.L., Heo, M., Papademetriou E., Meyers, B.S.
(2008). Predictors of Major Depression Six Months after Admission for Outpatient Treatment Psychiatric Services. ' ps.psychiatryonline.org ' 59 (10), 1211-1215
Woong, K.K., Han, W.J., Cho, H.J., Chang, C.B., Park, J.H., Lee, J.J., Lee, S.B.,
Seong, S.C., Kim, T.K.,(2011). Association between Comorbid Depression and Osteoarthritis Symptom Severity in Patients with Knee Osteoarthritis. The Journal of Bone & Joint Surgery, 93, 556-563
