Application Of Psychological Factors To The Diagnosis And Treatment Of Lumbar Disc Herniation

Objective:To assess the psychological status in patients with Lumbar Disc Herniation(LDH),and to explore psychological factors influencing the severity of clinical manifestations of patients with LDH.Preliminarily discuss the effect of psychological factors on patients after surgical treatment,thus for helping clinicians to treat patients with LDH.Methods:(1)Selected patients hospitalized with LDH in Spine Surgery Department in Southeast University Affiliated Zhongda Hospital from May 2015 to April 2017.By using Eysenck Personality Questionnaire(EPQ-RSC)and Hospital Anxiety Depression Scale(HAD)to assess the psychological status of patients with LDH.(2)The clinical outcomes were evaluated by the Oswestry Disability Index(ODI)and the Visual Analog Scale(VAS).(3)The experimental group and control group set to observe the surgical curative effect were hospitalized by the same group of physicians,and the operation was all performed by a same spine surgeon.All patients were discharged after the same days of same drugs therapy after the same operation.(4)Evaluated the clinical outcomes again by ODI and VAS when they were discharged.(5)Clinical examinations and personal interviews with questionnaires were carried out.Data bank was established and analysis of materials was performed by computer with SPSS 19.0 software.Results:(1)Each factor score in EPQ of LDH patients has no significant correlation(P>0.05).Compared with national norm,P,N scale of LDH group is higher than the norm group;E,L scale of LDH group is lower than the norm group.The differences between two groups have statistical significance,there are significant differences(P<0.05 or P<0.01).(2)In patients with LDH,P,E scale are not associated with anxiety and depression which were no significant(P>0.05);L scale is negatively related to the anxiety(P<0.05),no significantly associated with depression(P>0.05);N scale is positively related to the anxiety and depression(P<0.01).(3)In patients with LDH,P,E and L scales have no significant correlation with the VAS scores and ODI scores when patients got admission to the hospital(P>0.05);N scale has positive correlation with the VAS scores and ODI scores when patients got admission to the hospital(P<0.01).In patients with LDH,anxiety and depression are positively correlated(P<0.01).In patients with LDH,anxiety has positive correlation with the VAS scores and ODI scores when patients got admission to the hospital(P<0.01);Depression has positive correlation with the VAS scores and ODI scores when patients got admission to the hospital(P<0.05).(4)In patients with LDH,P,E scales have no significant correlation with postoperative the VAS score,the improvement rate of VAS score,the postoperative ODI score and the improvement rate of ODI score(P>0.05);N scale has positive correlation with the postoperative VAS score and the postoperative ODI score(P<0.01),meantime has negative correlation with the improvement rate of the VAS score and the ODI score(P<0.01).L scale has no significant correlation with the postoperative VAS score and the improvement rate of VAS score(P>0.05),and negatively related to the postoperative ODI score(P<0.05),and positively related to the improvement rate of ODI score(P<0.05).(5)In patients with LDH,anxiety and depression are positively related to the postoperative VAS score(P<0.01),have no significant correlation with the improvement rate of the VAS score(P>0.05);Anxiety and depression are positively related to the postoperative ODI score(P<0.01),and negatively related with the improvement rate of the ODI score(P<0.01).(6)Between High N score Group(n=81)and Low N score Group(n=56),It has a significant difference in the postoperative VAS score.postoperative ODI score and the improvement rate of the ODI score(P<0.01),but no significance in the improvement rate of the VAS score(P>0.05).(7)Between High L score Group(n=81)and Low L score Group(n=56),It has no significant difference in the postoperative VAS score.postoperative ODI score and the improvement rate of the ODI score(P<0.01),but no significance in the improvement rate of the VAS score(P>0.05).(8)Between High Depression Group(n=64)and Low Depression Group(n=73),It has a significant difference in the postoperative VAS score.postoperative ODI score and the improvement rate of the ODI score(P<0.01),but no significance in the improvement rate of the VAS score(P>0.05).(9)Between High Anxiety Group(n=80)and Low Depression Group(n=57),It has a significant difference in the postoperative VAS score?postoperative ODI score and the improvement rate of the ODI score(P<0.01),but no significance in the improvement rate of the VAS score(P>0.05).Conclusion:(1)People suffering from LDH will be mood swings more easily than the normal and easy in a state of anxiety or depression.(2)Patients with anxiety,depression or mood disorders,often be more easily suffered with pain and dysfunction,and whose clinical manifestation will be different with which their imaging examination or other objective examination suggested.(3)The postoperative residual symptoms of patients with higher N score are more severe than the lower patients,whose relief of pain and dysfunction by surgery are more less.(4)The postoperative residual symptoms of patients with higher L score are less severe than the lower neurotic patients,whose relief of dysfunction by surgery are more better.There are no significant difference in the relief of the pain related to the L score.(5)The postoperative residual symptoms of patients with with anxiety,depression are more severe than the lower patients,whose relief of pain and dysfunction by surgery are more less.