Post surgical depression

Pro Research Analysisby

Searched over 200M research papers

Analyzed relevant papers

Post-Surgical Depression: An Overview

Introduction to Post-Surgical Depression

Post-surgical depression is a significant concern for patients undergoing various surgical procedures. It is associated with increased morbidity, mortality, and prolonged recovery times. Understanding the prevalence, risk factors, and impacts of post-surgical depression is crucial for improving patient outcomes and quality of life.

Prevalence and Risk Factors of Post-Surgical Depression

General Surgery

Depression is a frequent complication following surgery, affecting a wide range of patients. It is commonly associated with cognitive impairment, increased postoperative pain, and a higher likelihood of chronic post-surgical pain . Depression can also lead to increased rates of postoperative infections and mortality, particularly in patients with malignant tumors or carcinomas .

Cardiothoracic Surgery

In cardiac surgical patients, depression is highly prevalent and significantly associated with increased mortality. Studies have shown that depressive scores rise significantly during hospitalization and gradually decrease post-discharge. Key predictors of high post-operative depression scores include female gender, low ejection fraction, and high preoperative depression scores . Additionally, depression and anxiety are common after coronary artery bypass surgery and can persist for up to a year, increasing the risk of new coronary events and further hospitalizations .

Lung Cancer Surgery

Patients undergoing surgical treatment for lung cancer also experience significant psychological distress. Postoperative depression rates increase notably, with risk factors including thoracotomy, postoperative dyspnea, severe pain, and diabetes mellitus . These findings highlight the need for careful psychological evaluation and management to improve postoperative quality of life.

Orthopedic Surgery

In orthopedic surgery, particularly lower limb arthroplasty, post-operative depression is common, with a higher prevalence observed compared to other surgical specialties. Female patients and those with a history of previous lower limb arthroplasty are more likely to develop post-operative depression .

Impact of Preoperative Depression on Post-Surgical Outcomes

Pain Outcomes

Preoperative depression has been linked to worse postoperative pain outcomes. A systematic review found that while some studies reported a significant effect of preoperative depression on postoperative pain, others did not, indicating a need for further large-scale studies . Another meta-analysis confirmed that preoperative depression is associated with greater pain scores shortly after surgery and at long-term follow-ups .

Recovery and Complications

Depression is an independent risk factor for prolonged hospital stays and increased postoperative complications. For instance, in patients undergoing anterior cervical discectomy and fusion, pre-surgical depression was associated with higher rates of post-surgical pain, complications, and longer hospital stays . Similarly, in major non-cardiac surgeries, depression predicted prolonged recovery times and was a significant factor in the discrepancy between anticipated and actual length of hospital stay .

Management and Interventions

Screening and Early Intervention

Early identification and management of depression in surgical patients are crucial. Tools like the Patient Health Questionnaire-9 (PHQ-9) and the Center for Epidemiological Study of Depression (CES-D) can help in screening for depression pre- and post-operatively 12.

Psychological Support

Providing psychological support and counseling interventions can ameliorate depression and improve surgical outcomes. For instance, supportive psychotherapy and pharmacological interventions have been beneficial for patients with postoperative psychological distress .

Conclusion

Post-surgical depression is a prevalent and serious issue that affects patient recovery and overall outcomes. Identifying at-risk patients through preoperative screening and providing timely psychological support can significantly improve postoperative recovery and quality of life. Further research is needed to develop comprehensive strategies for managing depression in surgical patients to enhance their long-term health and well-being.

Sources and full results

Most relevant research papers on this topic

Depression and postoperative complications: an overview

Depression is a frequent cause of morbidity and mortality in surgery patients, and counseling interventions may help ameliorate depression and improve outcomes.

Rigorous JournalHighly Cited

2016·

392citations

·M. Ghoneim et al.

Clinical, Surgical, and Socio-Psychological Factors and Depression Post-Cardiothoracic Surgery.

High depressive scores post-cardiac surgery suggest perioperative screening and management of depression may improve outcomes for these patients.

Observational Study

2020·

16citations

·Noa Caspi-Avissar et al.

Risk factors for postoperative anxiety and depression after surgical treatment for lung cancer†.

Postoperative anxiety and depression are common after lung cancer surgery, with thoracotomy, postoperative dyspnea, severe pain, and diabetes mellitus as risk factors.

Observational StudyRigorous JournalHighly Cited

2016·

100citations

·Samina Park et al.

Does preoperative depression predict post-operative surgical pain: A systematic review.

Pre-operative depression may predict post-operative pain, but the quality of presented data is poor and requires further large epidemiologic studies for confirmation.

Systematic Review

2017·

29citations

·A. Dadgostar et al.

Post-operative anxiety and depression levels in orthopaedic surgery: a study of 56 patients undergoing hip or knee arthroplasty.

Post-operative depression is common in orthopaedic surgery, with females and those with previous lower limb arthroplasty being more likely to develop it.

Observational Study

2009·

57citations

·R. Nickinson et al.

Longitudinal course of depressive, anxiety and post-traumatic stress disorder symptoms after heart surgery: a meta-analysis of 94 studies.

Depressive and anxiety symptoms improve over one-year after heart surgery, while PTSD symptoms may worsen, with older patients, those with metabolic comorbidities, valve disease, or ventricular arrhythmias at higher risk.

Meta-AnalysisRigorous Journal

2020·

14citations

·Stella Rosson et al.

A national snapshot of the impact of clinical depression on post-surgical pain and adverse outcomes after anterior cervical discectomy and fusion for cervical myelopathy and radiculopathy: 10-year results from the US Nationwide Inpatient Sample

Pre-surgical clinical depression predicts post-surgical acute or chronic pain, a slightly prolonged stay, and the presence of any complication in patients undergoing cervical discectomy and fusion in the US.

Observational StudyRigorous Journal

2021·

16citations

·Jiang Chen et al.

The impact of pre‐operative depression on pain outcomes after major surgery: a systematic review and meta‐analysis

Pre-existing depression before surgery is associated with worse postoperative pain severity, emphasizing the need for psychological care in postoperative pain management.

Meta-Analysis

2023·

12citations

·S. Lee et al.

Influence of Depression on Recovery After Major Noncardiac Surgery: A Prospective Cohort Study.

Depression is a strong independent predictor of prolonged length of stay after major abdominal surgery, partly explaining surgeons' failure to accurately predict outcomes.

Observational Study

2015·

27citations

·M. Orri et al.

Postoperative Complication and Depression: A Literature Review

Depression is a common complication in postoperative patients, leading to increased morbidity and mortality, and can worsen postoperative pain and increase the risk of long recovery.

Literature Review

2021·

0citations

·Sendy Aditya Nugraha

Try another search

important facts about ocd

helping people with depression

how quickly do vitamin d supplements work

types of anxiety disorders test

symptoms of anxiety in men

should i take probiotics with food