Yu ZP. Correlation of anxiety and depression with ankle function in chronic ankle instability patients and analysis of risk factors. World J Psychiatry 2025; 15(7): 103185 [DOI: 10.5498/wjp.v15.i7.103185]
Corresponding Author of This Article
Zu-Po Yu, MD, Doctor, Department of Orthopedics, The People’s Hospital of Pingyang and Pingyang Hospital Affiliated to Wenzhou Medical University and Pingyang Branch of Zhejiang Cancer Hospital, No. 555 Kun’ao Avenue, Kunyang Town, Pingyang County, Wenzhou 325400, Zhejiang Province, China. yuzupo123@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Jul 19, 2025; 15(7): 103185 Published online Jul 19, 2025. doi: 10.5498/wjp.v15.i7.103185
Correlation of anxiety and depression with ankle function in chronic ankle instability patients and analysis of risk factors
Zu-Po Yu
Zu-Po Yu, Department of Orthopedics, The People’s Hospital of Pingyang and Pingyang Hospital Affiliated to Wenzhou Medical University and Pingyang Branch of Zhejiang Cancer Hospital, Wenzhou 325400, Zhejiang Province, China
Author contributions: Yu ZP designed the research and wrote the first manuscript, contributed to conceiving the research and analyzing data, conducted the analysis and provided guidance for the research.
Institutional review board statement: This study was approved by the Ethic Committee of The People’s Hospital of Pingyang Country.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zu-Po Yu, MD, Doctor, Department of Orthopedics, The People’s Hospital of Pingyang and Pingyang Hospital Affiliated to Wenzhou Medical University and Pingyang Branch of Zhejiang Cancer Hospital, No. 555 Kun’ao Avenue, Kunyang Town, Pingyang County, Wenzhou 325400, Zhejiang Province, China. yuzupo123@163.com
Received: March 21, 2025 Revised: April 20, 2025 Accepted: May 19, 2025 Published online: July 19, 2025 Processing time: 110 Days and 19.4 Hours
Abstract
BACKGROUND
Psychological comorbidities, such as anxiety and depression, in patients with chronic ankle instability (CAI) may impede ankle function improvement, although the precise nature of this association warrants further investigation.
AIM
To analyze the correlation of anxiety and depression with ankle function in patients with CAI and discussing the risk factors.
METHODS
This study included 116 patients with CAI, who were admitted to our hospital from July 2022 to July 2024. Anxiety and depression states of patients were assessed with the self-rating anxiety scale (SAS) and self-rating depression scale (SDS), respectively, and their ankle joint function was assessed with the ankle-hindfoot function score of the American Orthopedic Foot and Ankle Society. Further, the ankle function of patients with CAI with different anxiety and depression states was discussed. Furthermore, the Pearson correlation coefficient was used to analyze the correlation of anxiety and depression with ankle joint function in such patients. Univariate and multivariate analyses were conducted to investigate the factors affecting ankle joint function in patients with CAI.
RESULTS
Among the 116 patients with CAI, 97, 13, 5, and 1 cases demonstrated none, mild, moderate, and severe anxiety, whereas 95, 15, 6, and 0 cases showed none, mild, moderate, and severe depression, respectively. The average ankle joint function score was 74.82 ± 6.93 points. The ankle joint function in patients with CAI presented a significant downward tendency as the degree of anxiety and depression increased. Correlation analysis revealed that both the SAS and SDS scores of patients with CAI were significantly negatively correlated with the ankle joint function score. Univariate and multivariate analyses indicated that the risk factors affecting patients’ ankle joint function included early functional rehabilitation, visual analog scale, and SDS.
CONCLUSION
A substantial number of patients with CAI suffer from anxiety and depression, and these negative emotions, to a certain extent, harm the smooth rehabilitation of ankle joint function.
Core Tip: The incidence of chronic ankle instability (CAI) reaches up to 53%, with nearly half of affected patients reporting negative emotions such as anxiety and depression. These psychological factors have negatively affected both treatment efficacy and functional recovery of the ankle. This study involved 116 patients with CAI and revealed that approximately 20.0% demonstrated varying severity of anxiety and depressive symptoms. Statistical analysis revealed a significant inverse correlation between the severity of patients’ anxiety/depression symptoms and their ankle functional outcomes. The study further determined three independent risk factors impairing ankle functional recovery: (1) Inadequate early functional exercise; (2) Increased pain levels as measured by the visual analog scale; and (3) Higher scores on the self-rating depression scale. These results indicate that clinical management should incorporate comprehensive psychological assessment and targeted interventions to optimize functional outcomes. Further, implementing early rehabilitation exercises and effective pain management strategies may help mitigate psychological distress while facilitating ankle function restoration.
