@article { author = {Jayakumar, Prakash and Kortlever, Joost T.P. and Brown, Laura E. and Ring, David}, title = {A Two Question Screen for Mental Health Opportunities}, journal = {The Archives of Bone and Joint Surgery}, volume = {9}, number = {3}, pages = {338-344}, year = {2021}, publisher = {Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association}, issn = {2345-4644}, eissn = {2345-461X}, doi = {10.22038/abjs.2020.42043.2143}, abstract = {Background: Shortened versions of validated PRO measures of coping strategies e.g. PSEQ-2, may facilitatescreening and monitoring of psychological conditions such as depression and anxiety. The primary researchquestion in this study assesses the sensitivity and specificity of a PSEQ-2 score of less than 10 for importantsymptoms of depression (a PHQ-2 score greater than 2), anxiety (GAD-2 score greater than 2), any impactfulprior episode of psychological trauma, and QuickDASH greater than 49. Secondarily we assess the associationsbetween self-efficacy and other demographic and psychological factors on the magnitude of limitations and painintensity.Methods: We performed a retrospective PRO evaluation in 926 adult patients attending upper extremity clinicbetween 1st January 2018 and 31st January 2019. Demographic factors were assessed using electronic medicalrecords and PRO data using an online platform. Patients included 556 (60%) women, 370 (40%) men (mean 51years + 14 (range, 19-88), mostly (n=584, 63%) with safety net insurance.Results: A PSEQ-2 scoring threshold of less than 10 was 81% sensitive for a PHQ-2 score of 3 or greater, 84%sensitive for a GAD-2 score of 3 or greater, 84% sensitive for one or more important psychological traumas, and 82%sensitive for a QuickDASH of 50 or greater. PSEQ-2 less than 10 was independently associated with greater upperextremity limitations (β=11 [6.3 to 17, 95% Confidence interval [C.I], p <0.001) and pain intensity (β=0.92 (0.31 to 1.5,95% C.I) P=0.003) amongst other psychological and demographic factors.Conclusion: A PSEQ-2 score less than 10 might, along with verbal and non-verbal signs of distress, be a usefulway to introduce the use of more sensitive screening questionnaires about anxiety or depression, or open up the option of speaking directly to mental or social health professionals. Future studies are required to test thishypothesis. Level of evidence: III}, keywords = {Anxiety,Depression,patient outcomes,Psychological factors,Resiliency,stress,Self-efficacy}, url = {https://abjs.mums.ac.ir/article_17000.html}, eprint = {https://abjs.mums.ac.ir/article_17000_e2a257163d86f7bfc6c94bba5304f441.pdf} }