Li Z, Liu J, Lei W, Wang LB, Yang ZW. Anxiety and depression status in geriatric patients undergoing total hip arthroplasty: Correlation with postoperative pain and risk factors. World J Psychiatry 2025; 15(9): 108010 [DOI: 10.5498/wjp.v15.i9.108010]
Corresponding Author of This Article
Zhi-Wei Yang, Associate Chief Physician, Department of Orthopedics, Changde Hospital, Xiangya School of Medicine, Central South University, The First People’s Hospital of Changde City, No. 818 Renmin Road, Yuanjiagang, Wuling District, Changde 415000, Hunan Province, China. yzw529529@126.com
Research Domain of This Article
Psychology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Sep 19, 2025; 15(9): 108010 Published online Sep 19, 2025. doi: 10.5498/wjp.v15.i9.108010
Anxiety and depression status in geriatric patients undergoing total hip arthroplasty: Correlation with postoperative pain and risk factors
Zheng Li, Jing Liu, Wen Lei, Li-Bo Wang, Zhi-Wei Yang
Zheng Li, Jing Liu, Li-Bo Wang, Zhi-Wei Yang, Department of Orthopedics, Changde Hospital, Xiangya School of Medicine, Central South University, The First People’s Hospital of Changde City, Changde 415000, Hunan Province, China
Wen Lei, Operating Room, Changde Hospital, Xiangya School of Medicine, Central South University, The First People’s Hospital of Changde City, Changde 415000, Hunan Province, China
Author contributions: Li Z participated in study design and provided guidance, designed the study, collected and analyzed data, and wrote the manuscript; Li Z, Liu J, Lei W, Wang LB and Yang ZW participated in the study’s conception and data collection; all authors read and approved the final version.
Institutional review board statement: This study was approved by the Ethic Committee of The First People’s Hospital of Changde City.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Wei Yang, Associate Chief Physician, Department of Orthopedics, Changde Hospital, Xiangya School of Medicine, Central South University, The First People’s Hospital of Changde City, No. 818 Renmin Road, Yuanjiagang, Wuling District, Changde 415000, Hunan Province, China. yzw529529@126.com
Received: May 30, 2025 Revised: July 4, 2025 Accepted: July 21, 2025 Published online: September 19, 2025 Processing time: 88 Days and 5.2 Hours
Abstract
BACKGROUND
Anxiety, depression, and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.
AIM
To investigate the prevalence of anxiety and depression among geriatric patients who underwent total hip arthroplasty (THA), explored their association with postoperative pain, and identified contributing risk factors.
METHODS
A total of 111 geriatric patients who underwent THA between January 2021 and January 2024 were included. Standardized psychological assessment tools-including the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS)-and the Numeric Rating Scale (NRS) for pain quantification were systematically administered. Pearson correlation analysis was utilized to explore the relationships among SAS, SDS, and NRS scores. Univariate and multivariate binary logistic regression analyses were conducted to identify risk factors for anxiety and depression in these patients.
RESULTS
The cohort exhibited moderate anxiety (SAS: 44.23 ± 9.03), mild depression (SDS: 46.98 ± 9.15), and moderate postoperative pain (NRS: 4.93 ± 2.37). Patients with anxiety or depression reported significantly higher NRS scores than those without these conditions. Significant positive correlations were observed between SAS and SDS scores, as well as between each of these and NRS scores. Univariate analysis revealed that gender, age, disease duration, alcohol use, diabetes history, and NRS scores were significantly associated with anxiety and depression. Multivariate analysis further identified female gender, disease duration ≥ 2 years, alcohol use, and NRS scores ≥ 5 as independent predictors of postoperative psychological distress.
CONCLUSION
Anxiety and depression are closely linked with postoperative pain in geriatric patients post-THA recovery. Early psychological screening and multimodal pain management strategies are recommended-particularly for individuals with a disease duration of ≥ 2 years, a history of alcohol consumption, or an NRS score of ≥ 5, as well as female patients-to effectively mitigate their negative emotional states and improve postoperative recovery.
Core Tip: Poor functional and recovery outcomes in patients with hip disorders are often linked to anxiety, depression, and postoperative pain. However, research identifying how anxiety and depression influence pain after total hip arthroplasty (THA) in older patients or their potential determinants is limited. Our findings indicate that a subset of older patients with THA experience anxiety and depression, which correlate with elevated levels of postoperative pain. Clinicians should closely monitor female patients, individuals with long-standing hip disease, alcohol consumers, and patients with high pain scores (assessed using the Numeric Rating Scale), as these groups are at a greater risk of psychological distress.
