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Relation between psychiatric disorder and abnormal illness behaviour in patients undergoing operations for cervical
R E Taylor1, F Creed, D Hughes
1University Department of Psychiatry, Manchester Royal Infirmary, UK.
Objective:
To test the hypothesis that depression in patients being considered for cervical disc surgery is associated with severe organic pathology. Secondly, to test whether depression and abnormal illness attitudes recorded preoperatively would predict poorer recovery.
Methods:
Seventy four patients with pain and disability from cervical arthrosis were examined during investigations before potential cervical surgery. The prevalence of psychiatric disorder was assessed using the SCAN, and attitude to illness using the illness attitude scale.
Results:
There was a rate of depressive disorder in the sample of 37%. The depressed patients did not have more severe organic pathology, more neurological symptoms or signs, or more disablement. They reported more pain and displayed more abnormal illness behaviour. Fifty patients went on to cervical surgery. Outcome four to eight months postoperatively was not related to the presence of psychiatric disorder or illness attitude recorded preoperatively.
Conclusion:
Depressive disorder is not secondary to severe pathology; the outcome of surgery is predominantly determined by physical factors.