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<a href="http://doi.org/10.1016/j.dhjo.2019.05.004" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.dhjo.2019.05.004</a>
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Title
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An examination of pain, disability, and the psychological correlates of Chiari Malformation pre- and post-surgical correction
Publisher
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Disability and Health Journal
Date
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2019
2019-05
Subject
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Chiari malformation; Decompression surgery; Disability; Pain; Psychological symptoms
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Garcia Monica A; Allen Philip A; Li Xuan; Houston James R; Loth Francis; Labuda Rick; Delahanty Douglas L
Description
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BACKGROUND: 50% of patients with Chiari Malformation (CM) report a history of depression; however, rates of other psychological symptoms are unknown. Further, it is unclear whether surgical correction impacts pain, disability, and psychological symptoms. OBJECTIVE: /Hypothesis: We examined rates of symptoms in a nationwide sample of CM patients who had (n = 639) and had not (n = 551) undergone surgical correction. We hypothesized lower symptom severity in the latter group. METHODS: Participants completed assessments and submitted pre-surgical MRI scans online (n = 286). Informed by the Fear-Avoidance Model of pain, we controlled for psychological symptoms when assessing pain/disability, and pain/disability when assessing psychological symptoms. RESULTS: Overall, high rates of depression (44% moderate-severe) and anxiety (60% moderate-severe) were reported. Groups (surgery vs. no-surgery) did not differ in the proportion of patients meeting cutoff scores for current disability; however, the no-surgery group was more likely to meet cutoffs for anxiety (χ2 = 11.26, p < .05), stress (χ2 = 14.63, p < .01) and health anxiety (χ2 = 4.63, p < .05). The surgery group reported lower levels of continuous affective pain F(1, 1065) = 10.28, p < .001), anxiety F(1,1026) = 4.96, p < .05) and stress F(1, 978) = 5.67, p < .05) although effect sizes were small (η2s ranging from 0.010 to 0.006, Cohen's D ranging from 0.17 to 0.25). CONCLUSION: CM patients experience high rates of psychological symptomatology regardless of surgical status, suggesting that all CM patients may benefit from evidence-based interventions to address anxiety and depression.
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<a href="http://doi.org/10.1016/j.dhjo.2019.05.004" target="_blank" rel="noreferrer noopener">10.1016/j.dhjo.2019.05.004</a>
2019
Allen Philip A
Chiari malformation
Decompression surgery
Delahanty Douglas L
Department of Psychiatry
disability
Disability and health journal
Garcia Monica A
Houston James R
June 2019 Update
Labuda Rick
Li Xuan
Loth Francis
NEOMED College of Medicine
Pain
Psychological symptoms