This systematic review of 29 surgical outcomes studies (1990–2004) asks whether psychosocial factors — mood, attitude, social support, coping, and personality — independently predict clinical recovery after surgery, above and beyond known demographic and clinical variables. Only studies using multivariate regression with clinical covariates were included.
When planning orthopaedic surgery, screen specifically for preoperative anxiety, depression, and patient expectations — not generic 'emotional distress.' A patient who is depressed or has unrealistically high expectations of pain relief (especially before lumbar procedures) is at elevated risk for poor functional recovery, and that risk is independent of the surgical findings on imaging.
This systematic review of 29 surgical outcomes studies (1990–2004) asks whether psychosocial factors — mood, attitude, social support, coping, and personality — independently predict clinical recovery after surgery, above and beyond known demographic and clinical variables. Only studies using multivariate regression with clinical covariates were included.
When planning orthopaedic surgery, screen specifically for preoperative anxiety, depression, and patient expectations — not generic 'emotional distress.' A patient who is depressed or has unrealistically high expectations of pain relief (especially before lumbar procedures) is at elevated risk for poor functional recovery, and that risk is independent of the surgical findings on imaging.