Researchers have determined in a new study that psychological distress is extremely common in adolescents and young adults presenting with hip pain and is strongly correlated with poorer patient-rated pain and dysfunction. Young adults were at risk of depression, and extreme psychological distress was prevalent in female patients, obese patients, and those who had undergone previous hip surgery. The study was published in The Journal of Bone and Joint Surgery by Michael C. and colleagues.
The research involved 500 patients between the ages of 10 and 24 years who had hip pain for the first time when attending their initial orthopaedic clinic. All the patients fulfilled three evidence-based screening instruments: Patient Health Questionnaire-9 (PHQ-9) for symptoms of depression, 17-item Optimal Screening for Prediction of Referral and Outcome-Yellow Flag (OSPRO-YF) for psychological distress, and International Hip Outcome Tool-12 (iHOT-12) for patient-reported function of the hip.
Depression was classified as mild or less versus moderate or more by PHQ-9 score.
Psychological distress was classified as none/mild, moderate, or severe by OSPRO-YF scores.
Predictors including age, sex, BMI, previous surgery, and diagnosis were evaluated by logistic regression models.
Functional outcomes (iHOT scores) were compared between groups.
Results
The findings showed a significant prevalence of psychological distress and depression symptoms in the young population with hip pain.
10.6% of patients reported moderate or more depression symptoms.
26.9% of patients reported severe psychological distress.
Young adults (20–24 years) were 2.09 times more likely to have moderate or more depression symptoms than adolescents aged 10–19 years (p = 0.016).
Female patients were 1.86 times at increased risk of severe psychological distress (p = 0.026).
Patients who underwent previous hip surgery were at 2.29 times increased risk (p = 0.025).
Overweight patients were at 2.10 times greater risk of severe psychological distress (p = 0.008).
The research proved that psychological distress is prevalent among adolescents and young adults with hip pain and is associated with poorer pain and functional outcomes. Young adults are more vulnerable to depression symptoms, while substantial psychological distress occurs most frequently in females, obese patients, and those with previous hip surgery.
Reference:
Willey, M. C., Seffker, C. J., Jensen, J., Murray, T., Bender, N., Kochuyt, A., Lentz, T. A., Gao, Y., & Westermann, R. W. (2025). Psychological Distress Is Common and Associated with Greater Hip Dysfunction in Adolescents and Young Adults. The Journal of bone and joint surgery. American volume, 107(17), 1949–1956. https://doi.org/10.2106/JBJS.24.01219
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