Results Weak to moderate cross-sectional associations were found for emotional or mental health with function or disability and pain in multiple studies .
Lower emotional or mental health function was associated with greater pain or disability or lower physical function at initial evaluation .
Conclusions At the initial evaluation of patients with rotator cuff tear , there was an association between self-reported function and pain and emotional or mental health .
However , these factors were not associated with patient-reported outcomes after intervention .
Preoperative patient expectation is an important predictor of patient-reported outcomes in patients after rotator cuff surgery and may be a modifiable target for enhancing recovery .
Background Psychosocial factors are key determinants of health and can influence patient-reported outcomes after rotator cuff tears .
However , to our knowledge , a systematic review of published studies has not been conducted to determine the degree of consistency and strength of the relationship between psychosocial factors and patient-reported outcomes in this patient population .
Questions / purpose s ( 1 ) Are psychosocial factors associated with patient-reported measures at initial clinical presentation in patients with rotator cuff tears ? (
2 ) Are psychosocial factors associated with patient-reported outcomes after treatment in patients with rotator cuff tears ?
Psychological Distress Negatively Affects Self-assessment of Shoulder Function in Patients With Rotator Cuff Tears
Background In many areas of orthopaedics , patients with greater levels of psychological distress report inferior self- assessment s of pain and function . This effect can lead to lower-than-expected baseline scores on common patient-reported outcome scales , even those not traditionally considered to have a psychological component . Questions / purpose sThis study attempts to answer the following questions : ( 1 ) Are higher levels of psychological distress associated with clinical ly important differences in baseline scores on the VAS for pain , the Simple Shoulder Test , and the American Shoulder and Elbow Surgeons score in patients undergoing arthroscopic rotator cuff repair ? ( 2 ) Does psychological distress remain a negative predictor of baseline shoulder scores when other clinical variables are controlled ? Methods Eighty-five patients with full-thickness rotator cuff tears were prospect ively enrolled . Psychological distress was quantified using the Distress Risk Assessment Method question naire . Patients completed baseline self- assessment s including the  VAS for pain ,  the  Simple Shoulder Test  , and the  American Shoulder and Elbow Surgeons score . Age , sex , BMI , smoking status , American Society of Anesthesiologists classification , tear size , and tear retraction were recorded for each patient . Bivariate correlations and multivariate regression models were used to assess the effect of psychological distress on patient self- assessment of shoulder pain and function . Results Distressed patients reported higher baseline VAS scores ( 6.7 [ 95 % CI , 4.4–9.0 ] versus 2.9 [ 95 % CI , 2.3–3.6 ] , p = 0.001 ) and lower baseline Simple Shoulder Test ( 3.7 [ 95 % CI , 2.9–4.5 ] versus 5.7 [ 95 % CI 5.0–6.4 ] , p = 0.001 ) and American Shoulder and Elbow Surgeons scores ( 39 [ 95 % CI , 34–45 ] versus 58 [ 95 % CI , 53–63 ] , p < 0.001 ) . Distress remained associated with higher VAS scores ( p = 0.001 ) and lower Simple Shoulder Test ( p < 0.001 ) and American Shoulder and Elbow Surgeons scores ( p < 0.001 ) when age , sex , BMI , American Society of Anesthesiologists classification , smoking status , tear size , and tear retraction were controlled . Conclusions Higher levels of psychological distress are associated with inferior baseline patient self- assessment of shoulder pain and function using the VAS , the Simple Shoulder Test , and the American Shoulder and Elbow Surgeons score . Longitudinal followup is warranted to clarify the relationship between distress and self-perceived disability and the effect of distress on postoperative outcomes  after arthroscopic rotator cuff repair .  Level of Evidence Level I , prognostic study . See the Instructions for Authors for a complete description of levels of evidence
Results Weak to moderate cross-sectional associations were found for emotional or mental health with function or disability and pain in multiple studies .
Lower emotional or mental health function was associated with greater pain or disability or lower physical function at initial evaluation .
Conclusions At the initial evaluation of patients with rotator cuff tear , there was an association between self-reported function and pain and emotional or mental health .
However , these factors were not associated with patient-reported outcomes after intervention .
Preoperative patient expectation is an important predictor of patient-reported outcomes in patients after rotator cuff surgery and may be a modifiable target for enhancing recovery .
Background Psychosocial factors are key determinants of health and can influence patient-reported outcomes after rotator cuff tears .
However , to our knowledge , a systematic review of published studies has not been conducted to determine the degree of consistency and strength of the relationship between psychosocial factors and patient-reported outcomes in this patient population .
Questions / purpose s ( 1 ) Are psychosocial factors associated with patient-reported measures at initial clinical presentation in patients with rotator cuff tears ? (
2 ) Are psychosocial factors associated with patient-reported outcomes after treatment in patients with rotator cuff tears ?