Literature Collection

PURPOSE: To examine the prevalence and association of mental health symptoms, social factors, and healthcare experiences in individuals diagnosed with Scheuermann's disease (SD). METHODS: We analyzed self-reported data from the Scheuermann's Disease Fund (SDF) CoRDS registry from September 2021 to March 2025, which included 168 patients. Of these patients, 106 self-reported a Cobb angle. Participants completed a 196-item questionnaire covering demographics, curve severity, mental health domains of anxiety, depression, PTSD, and social isolation, healthcare experiences, and social factors. Statistical analyses, including descriptives and chi-square tests (α = 0.05), were conducted with IBM SPSS Statistics v30. RESULTS: Patients diagnosed with SD in these specific cohort were between the ages of 11-20 (59.5%), 21-40 (28.0%), and > 41 (12.5%) years, with thoracic kyphosis Cobb angle < 60º (15.1%), 61-80° (40.6%) or 81° and above (44.3%). Patients often reported pain (73.2%), with 37.3% reporting severe pain or worse. In total, 46.1% reported anxiety, 45.2% reported depression, 9.6% reported PTSD, and 63.0% reported social isolation. Depression was associated with chronic pain (r = 0.27, p < 0.001), and anxiety was correlated with social isolation (r = 0.26, p = 0.001). Over 72.0% of the patients felt misunderstood, and 65.1% lacked mental health referrals to receive appropriate counseling. Patients expressed that they did not believe their physician could understand or treat their condition, with 52.6% visiting at least two to four doctors before finding adequate care that met their unique needs. CONCLUSIONS: SD imposes substantial mental health burden, with many patients experiencing anxiety, depression, or feelings of social isolation. Many patients reported challenges in finding specialty care. These findings suggest the need for further research to determine whether earlier diagnosis and integrated care could improve outcomes.

OBJECTIVES: Depressive disorders are common in the primary care setting. Despite its high prevalence, depression treatment in primary care is less guideline-oriented compared to specialized settings, which often makes it less efficient. Current research has focused on explanations on the practitioner's side but has neglected the patient's perspective and its effect on treatment largely. METHODS: We conducted a scoping review on the electronic databases Medline and Psycinfo. Eligible publications contained information of the patients' perspective on depression treatment in primary care in OECD member states. Publications until August 2nd 2023 were considered. RESULTS: After the removal of duplicates, the search yielded 14.059 articles, of which 232 were included. Current literature focuses on behavioral and obvious measures like satisfaction, and on patient-sided barriers and facilitators to adherence. Other treatment-related behaviors are less researched. Patients with undiagnosed depression often report exclusively or mainly physical symptoms in general practice. CONCLUSION: This review provides a comprehensive framework for the concept. Research on barriers and facilitators to depression treatment in primary care is still inconclusive. Educating patients and addressing stigmatizing beliefs are promising targets to promote the seeking out, initiation of, and adherence to treatment. Being aware of a hidden depression when somatic symptoms are present, can help to detect more cases. REGISTRATION: This review is registered via OSF (https://osf.io/p9rnc).

As Canadian healthcare moves toward integrated care, it lacks "North Star" metrics, relying instead on hospital-centric indicators that miss the patient experience. Building on the integrated care framework by Anne Wojtak and Jodeme Goldhar, this paper argues for shifting from measuring system activity to measuring the burden placed on patients and caregivers. It proposes three new metrics: the System Friction Ratio, the Caregiver Latency Index and the Patient-Reported Burden Score. To achieve true population health, we must stop counting hospital-focused administrative outputs and start measuring the friction patients and families face when navigating the system.