A report on the prevalence of depression and anxiety in patients with frozen shoulder and their relations to disease status

Musculoskeletal diseases often have concomitant psychological disorders, such as depression and anxiety. Frozen shoulder (FS) is a musculoskeletal disease, and causes pain and stiffness in the shoulder. The relationship between FS and psychological disorders has rarely been investigated. This cross-sectional study was to evaluate the risk of depression and anxiety in patients with primary FS, and to explore the relationship between psychological disorders and disease status. In this study, anxiety and depression were evaluated in 124 patients (78 women and 46 men) with primary FS, compared with 130 (72 women and 58 men) age-, sex-and education matched healthy controls between March 2009 and June 2012. Simple shoulder test (SST); shoulder pain and disability index (SPADI); the range of motion (ROM); visual analog scales (VAS) for pain and sleep disturbances; hospital anxiety and depression scale for depression (HADS-D) and for anxiety (HADS-A); and health assessment questionnaire (HAQ) were used to assess clinical and psychological status. In FS patients, the prevalence of depression and anxiety was 28.2 and 24.2%, respectively. Compared with the healthy controls, higher HADS-D (6.41 +/- 3.69, 5. 23 +/- 2.87 p = 0.006) and HADS-A (6.16 +/- 3.62, 4.90 +/- 3.05 p = 0.003) were detected. The FS patients with depression or anxiety had significantly lower SST and HAQ scores, significantly higher VAS and SPADI scores and significantly higher prevalence of sleep disturbances compared with the FS patients with normal psychological status. The correlations of SST, SPADI, VAS and sleep disturbances but not ROM with HADS-A and HADS-D were significant (p < 0.05). This finding indicates that anxiety and depression may coexist with FS; patients with psychological disorders have more severe self-reported shoulder pain and functional restriction.