A Two Question Screen for Mental Health Opportunities

Area of Science:

• Orthopedics
• Psychology
• Rehabilitation

Background:

• Shortened Patient-Reported Outcome (PRO) measures, like the PSEQ-2, can aid in screening for psychological conditions.
• Validated PRO measures are crucial for monitoring conditions such as depression and anxiety.

Purpose of the Study:

• To assess the sensitivity and specificity of a PSEQ-2 score < 10 for identifying symptoms of depression (PHQ-2 > 2), anxiety (GAD-2 > 2), psychological trauma, and significant upper extremity limitations (QuickDASH > 49).
• To explore associations between self-efficacy, demographic factors, and psychological elements with pain intensity and functional limitations.

Main Methods:

• A retrospective evaluation of 926 adult patients in an upper extremity clinic.
• PRO data collected via an online platform; demographic data from electronic medical records.
• Analysis included sensitivity, specificity, and regression models to assess associations.

Main Results:

• A PSEQ-2 score < 10 demonstrated 81-84% sensitivity for detecting depression, anxiety, psychological trauma, and high QuickDASH scores.
• PSEQ-2 < 10 was independently associated with increased upper extremity limitations and pain intensity.
• Self-efficacy and other factors were linked to pain and functional limitations.

Conclusions:

• A PSEQ-2 score < 10 may serve as a valuable initial screen for psychological distress in upper extremity patients.
• This score could prompt further screening or direct consultation with mental health professionals.
• Further research is needed to validate this screening approach.