Psychiatric correlates of recurrent shoulder dislocations: the role of attention deficit hyperactivity disorder, impulsivity, and depression.

OBJECTIVES

One of the most common reasons for shoulder instability is recurrent shoulder instability. Arthroscopic repair is an option in the surgical treatment of Bankart lesions, and it is indicated if certain criteria are met. Recent evidence suggests that neurobehavioral traits may predispose individuals to orthopedic injuries. Therefore, we aimed to investigate the correlation between psychiatric parameters and recurrent dislocations in patients treated with arthroscopic Bankart repair.

METHODS

A total of 83 patients were included in the study, including 42 patients who underwent arthroscopic Bankart surgery due to recurrent shoulder dislocation (RSD) and 41 demographically matched healthy volunteers. The evaluated functional data included parameters such as Constant shoulder score and Rowe score for instability. Psychiatric parameters such as attention deficit hyperactivity disorder (ADHD), the Baratt impulsiveness Scale (BIS-11) and the Depression Anxiety and Stress Scale (DASS-21) were also evaluated.

RESULTS

The mean Constant shoulder score was 86.07 ± 12.07 (excellent) and the mean Rowe instability score was 81.26 ± 18.23 (good). The following psychiatric parameters were significantly greater in the patient group than in the control group.

CONCLUSIONS

RSD patients were found to have significantly higher postoperative ADHD, BIS-11 and DASS-21 scores. Existing ADHD and impulsivity may represent behavioral traits associated with RSD. Higher DASS-21 scores in patients are associated with depression. We recommend that routine psychiatric evaluation for ADHD and impulsivity should be considered in the management of patients with RSD to improve outcomes and prevent recurrence.