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The Joint EBJIS-MSIS 2026 Conference
17 - 19 September, 2026 | Porto, Portugal
EP163
Mending More Than Bones: Mental Health in Orthopedic Infectious Disease Patients
Poster Presenter
Part of Topic
Infectious Diseases
Mending More Than Bones: Mental Health in Orthopedic Infectious Disease Patients
Wajeeha Tariq, Amy Chang, Marilyn Chow, Jenny Aronson, Daisuke Furukawa, Jose Maldonado, Scott Mathis, Elizabeth Thottacherry
Correspondence: ethottac@stanford.edu
Introduction
•The prevalence of anxiety and depression in the general population ranges from 8-21%
•Bone and joint infections can require extended antimicrobial therapy and multiple surgical procedures
•These infections are associated with significant pain and functional impairment
Aims
The aim of this prospective study was to compare the anxiety and depression status in patients with orthopedic infections by multiple characteristics including:
•Comorbidities
•Quality of life
•Medical management
•Surgical management
Methods
•Patients in a combined orthopedic and infectious disease clinic were asked to complete an online survey before or after each scheduled visit.
•The survey entailed the following components:
1.Pre-survey questionnaire
2.Hospital Anxiety and Depression Scale (HADS)
3.The Medical Outcomes Study Social Support Survey (SF-20)
4.8-item financial well-being scale.
•Clinical variables were extracted from medical records
•Group differences in continuous variables were assessed with Welch’s t‑tests and categorical variables with Fisher’s exact tests
•p<0.05 was considered significant
•Patients were supplied handouts about emergency contacts and mental health assistance post survey
Results
•Total patients: 77
•18 (23%) screened positive for anxiety and 22 (29%) screened positive for depression
•No differences were seen based on gender, age or financial status
•No differences were seen based on presence of hardware, number of surgeries and duration since last surgery
•Greater psychotropic medication use was noted in the mild, moderate and severe anxiety groups
•Those who met criteria for depression were noted to have a significantly higher rate of prior anxiety, prior depression diagnosis
•Infections involving the spine were associated with mild, moderate and severe depression, though absolute total of spinal infections evaluated was relatively small
•Elevated anxiety was associated with lower physical and role functioning, lower health perception and lower mental health scores
•Elevated depression was associated with lower physical, role and social functioning and lower mental health scores
Conclusion
•In our clinic cohort, the prevalence of anxiety and depression based on the HADS screen exceeded general population estimates
•Our study shows that positive anxiety and depression screens were associated with worse SF-20 outcomes
•These findings support routine mental health screening and referral as part of bone and joint care
References:
Zhang Z, Chen X, Wu S, et al. Global, Regional and National Burden of Anxiety and Depression Disorders From 1990 to 2021, and Forecasts Up to 2040. J Affect Disord. 2025.
Vigo DV, Stein DJ, Harris MG, et al. Effective Treatment for Mental and Substance Use Disorders in 21 Countries. JAMA Psychiatry. 2025.
Patel R. Periprosthetic Joint Infection. N Engl J Med. 2023.
Knebel C, Menzemer J, Pohlig F, et al. Peri‑Prosthetic Joint Infection of the Knee Causes High Levels of Psychosocial Distress: A Prospective Cohort Study. Surg Infect (Larchmt). 2020. PMID: 32282286.