Commentary: Patterns and Impact of Electronic Health Records-Defined Depression Phenotypes in Spine Surgery

The reviewers would like to commend the authors of “Patterns and Impact of Electronic Health Records-Defined Depression Phenotypes in Spine Surgery” for their excellent manuscript. In this large review of the IBM MarketScan database, patients undergoing spine surgery were stratified into 5 ordinal groups of varying severity of depressive phenotype. These groups included those with diagnosis of major depressive disorder (MDD), other depression (patients with other non-MDD-type depression), patients on antidepressants for other mental health disorders (ie, anxiety), patients on antidepressants for other physical conditions (ie, neuropathic pain disorders), and patients with psychiatric conditions other than MDD but not on antidepressants. Each group represented a sequentially less severe phenotype of depression. Finally, there was a cohort of patients without any diagnosis of depression or prescription for antidepressants. Further analysis demonstrated that patients with more severe depression phenotypes were more likely to incur higher healthcare resource utilization, chronic opioid use, in-hospital...