{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:26:46Z","timestamp":1790623606499,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study using a nationally representative inpatient database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the incidence, timing, and predictors of new-onset psychiatric disorders following lumbar fusion surgery, and to propose a data-driven risk stratification model for early identification and intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We queried the Nationwide Readmissions Database (2016-2019) to identify adults undergoing elective inpatient lumbar fusion. Patients with preexisting psychiatric diagnoses were excluded. Outcomes included new-onset depression, anxiety, suicidal ideation, and homicidal ideation within 12\u00a0months postoperatively. Predictors were assessed using odds ratios. Timing of onset was evaluated with density plots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 839,576 patients, 12,011 developed depression, 11,828 anxiety, 916 suicidal ideation, and 63 homicidal ideation. Most diagnoses occurred within 90\u00a0days postoperatively, with peak incidence around 3\u00a0weeks. Opioid use during the index admission significantly increased odds of suicidal ideation (OR 2.13,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001), anxiety (OR 1.26,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002), and showed a trend toward depression (OR 1.14,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.087). Medicaid insurance was the strongest predictor of suicidal (OR 3.69) and homicidal ideation (OR 6.41). Female sex and younger age were associated with anxiety and depression; older age was protective against ideation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>New-onset psychiatric disorders are a frequent and early complication following lumbar fusion. Several modifiable and demographic factors - including perioperative opioid use and socioeconomic status - significantly predict risk. These findings underscore the need for structured mental health screening within the first 3\u00a0months post-surgery. Implementing a predictive risk stratification tool could enable earlier psychiatric referral, reduce long-term morbidity, and improve both recovery trajectories and overall quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251400284","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T11:06:29Z","timestamp":1763377589000},"page":"2212-2219","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["New-Onset Psychiatric Disorders After Lumbar Fusion: Predictors, Timing, and Risk Stratification"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2819-3831","authenticated-orcid":false,"given":"Alexander M.","family":"Ballatori","sequence":"first","affiliation":[{"name":"University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Shahrestani","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8891-0353","authenticated-orcid":false,"given":"Andy","family":"Ton","sequence":"additional","affiliation":[{"name":"University of California, Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao T.","family":"Chen","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5680-0643","authenticated-orcid":false,"given":"Zorica","family":"Buser","sequence":"additional","affiliation":[{"name":"NYU"},{"name":"Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Wang","sequence":"additional","affiliation":[{"name":"University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-025-08733-z"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682251318958"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2016.10.124"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000818"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000011"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2024-105599"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000001730"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2020.106098"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000916"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000005213"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.14444\/2011"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.09.013"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-1709-6"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12584"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","unstructured":"Lim CX Mueller EA Short LB Xia R Suvanbenjakule P O\u2019Brien WH. Inflexible responses to uncertainty: the mediating role of psychological inflexibility in the link between intolerance of uncertainty traumatic stress and somatic symptoms. Psychol Trauma. 2025. doi:10.1037\/tra0001860. Advance online publication.","DOI":"10.1037\/tra0001860"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7467"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.3171\/2022.11.FOCUS22619"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000916"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000064"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002616"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003338"},{"key":"e_1_3_5_23_2","doi-asserted-by":"crossref","unstructured":"Uysal E \u00c7ine H\u015e Azizo\u011flu S\u0130. 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