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Health-related QOL variables were examined preoperatively and at the 2-year postoperative follow-up. Patients were grouped by their 36-Item Short Form Health Survey mental component summary (MCS) and physical component summary (PCS) scores. Both groups had PCS scores \u2264 25th percentile for matched norms; however, the low mental health (LMH) group consisted of patients with an MCS score \u2264 25th percentile, and the high mental health (HMH) group included patients with an MCS score \u2265 75th percentile.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Of the 264 patients (72.3%) with a 2-year follow-up, 104 (28.5%) met the inclusion criteria for LMH and 40 patients (11.0%) met those for HMH. The LMH group had a significantly higher overall rate of comorbidities, specifically leg weakness, depression, hypertension, and self-reported neurological and psychiatric disease processes, and were more likely to be unemployed as compared with the HMH group (p &lt; 0.05 for all). The 2 groups had similar 2-year postoperative improvements in HRQOL (p &gt; 0.05) except for the greater improvements in the MCS and the Scoliosis Research Society-22r questionnaire (SRS-22r) mental domain (p &lt; 0.05) in the LMH group and greater improvements in PCS and SRS-22r satisfaction and back pain domains (p &lt; 0.05) in the HMH group. The LMH group had a higher rate of reaching a minimal clinically important difference (MCID) on the SRS-22r mental domain (p &lt; 0.01), and the HMH group had a higher rate of reaching an MCID on the PCS and SRS-22r activity domain (p &lt; 0.05). On multivariable logistic regression, having LMH was a significant independent predictor of failure to reach an MCID on the PCS (p &lt; 0.05). At the 2-year postoperative follow-up, 14 LMH patients (15.1%) were categorized as HMH. Two LMH patients (2.2%), and 3 HMH patients (7.7%) transitioned to a PCS score \u2265 75th percentile for age- and sex-matched US norms (p &lt; 0.01).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>While patients with poor mental and physical health, according to their MCS and PCS scores, have higher medical comorbidity and unemployment rates, they still demonstrate significant improvements in HRQOL measurements postoperatively. Both LMH and HMH patient groups demonstrated similar improvements in most HRQOL domains, except that the LMH patients had difficulties in obtaining improvements in the PCS domain.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.5.spine151428","type":"journal-article","created":{"date-parts":[[2016,8,19]],"date-time":"2016-08-19T14:02:45Z","timestamp":1471615365000},"page":"116-124","source":"Crossref","is-referenced-by-count":57,"title":["Impact of poor mental health in adult spinal deformity patients with poor physical function: a retrospective analysis with a 2-year follow-up"],"prefix":"10.3171","volume":"26","author":[{"given":"Joshua","family":"Bakhsheshian","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin K.","family":"Scheer","sequence":"additional","affiliation":[{"name":"University of California, San Diego, School of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Gum","sequence":"additional","affiliation":[{"name":"Norton Leatherman Spine Center, Louisville, Kentucky;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Hostin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Baylor Scoliosis Center, Plano, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[{"name":"Rocky Mountain Hospital for Children, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Themistocles S.","family":"Protopsaltis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas C.","family":"Burton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malla Kate","family":"Keefe","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Oregon Health & Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M.","family":"Mundis","sequence":"additional","affiliation":[{"name":"Scripps Health, La Jolla;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine151428","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1227\/NEU.0000000000000695","article-title":"The relationship between preoperative general mental health and postoperative quality of life in minimally invasive lumbar spine surgery","volume":"76","author":"Asher R,","year":"2015","unstructured":"Asher R, Mason AE, Weiner J, Fessler RG: The relationship between preoperative general mental health and postoperative quality of life in minimally invasive lumbar spine surgery. 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