The Impact of Depression and Antidepressant Treatment on Patient-Reported Outcomes Following Thumb Carpometacarpal...

Depression, a leading cause of disability, is a known predictor of poorer outcomes in upper-extremity procedures. Associated mood and somatic symptoms may interfere with the assessment of postoperative recovery, making it difficult to distinguish between postoperative-related symptoms and those linked to depression. This study examines the impact of depression on patient-reported outcomes following carpometacarpal (CMC) arthroplasty (trapeziectomy with ligament reconstruction and tendon interposition) for basilar thumb arthritis. We hypothesized that patients with a diagnosis of major depressive disorder or active antidepressant treatment before surgery will have poorer upper-extremity outcomes at 1 year compared with patients without depression.

Patients who underwent isolated thumb CMC arthroplasty at a single academic center were screened for inclusion. Baseline demographic data, psychiatric history, and antidepressant use at the time of surgery were collected retrospectively. Patients with concomitant psychiatric diagnoses other than depression, those undergoing multiple procedures at the time of thumb CMC arthroplasty, or individuals with additional chronic upper-extremity pathology were excluded. The Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire was administered before surgery to establish baseline scores and at 3, 6, and 12 months after surgery. Quick Disability of the Arm, Shoulder, and Hand scores were analyzed using an independent samples t test and a linear mixed effects model to adjust for the time from surgery, sex, race, and body mass index at the time of surgery.

Seventy-three (22.3%) of 328 patients had a diagnosis of depression or were receiving antidepressant treatment at the time of surgery. Before surgery, the average QuickDASH score was 41.4 for the patients with depression and 40.3 for patients without. At 1 year after surgery, these averages were 28.8 and 24.0, respectively. No significant difference in QuickDASH scores was observed between patients with depression or receiving antidepressant treatment and those without at any time point.

This study demonstrates no significant difference in postoperative QuickDASH scores between patients with a diagnosis of depression or antidepressant treatment and those without following thumb CMC arthroplasty. These findings suggest that a history of depression may not adversely affect patient-reported outcomes after thumb CMC arthroplasty.

Prognostic IV.