Abstract
IntroductionUp to 80% of patients scheduled for surgery experience preoperative anxiety, which may implicate perioperative psychological and physical discomforts. Several studies focused on this phenomenon in neurosurgical setting, still controversial evidence exists.ObjectivesOur aim is to synthesize this evidence, investigating prevalence, implications and therapy of preoperative anxiety in brain surgery patients.MethodsWe performed a systematic review of literature by searching PubMed, Embase, and Cochrane Library databases. Data were extracted using the PICO framework. PRISMA guidelines were applied, and the risk of bias was assessed using the RoB 2 and ROBINS tools, as was the methodological quality of the included studies, following GRADE criteria; we excluded articles with serious risk of bias and/or low quality.ResultsWe included 27 articles, accounting for 2558 patients of twelve different countries. Prevalence of anxiety before brain surgery was up to 89%, reaching higher levels in women. Anxiety concerned mostly anesthesia and surgical outcome. No correlation emerged between level of anxiety and laterality, histological type of tumor or survival rate. Before surgery, anxious patients performed worse in cognitive tasks and had worse subjective evaluation of their cognitive abilities. After surgery, preoperative anxiety was associated with depression, longer hospitalization, increase of physical disability and lower quality of life. Effective approaches to reduce anxiety were acupuncture, music therapy, virtual reality and pharmacological support.ConclusionsPreoperative anxiety in brain surgery patients is a common experience that should not be underestimated to achieve a better perioperative care through early detection and adequate pharmacological or non-pharmacological management.
Highlights
Most mental disorders tend to relapse, which are potentially recoverable and yet, tend to evolve poorly, persisting residual symptoms without achieving a complete recovery
Patients with somatoform disorders almost benefitted from both psychoeducation and group analysis but group analysis psychotherapy led to better awareness of psychological and risk factors of their illness
It would be a mistake to consider it as pathological and try to eliminate it through medication or psychotherapy, since we could interfere with the natural recovery processes, contributing to its chronification and preventing possibility of change
Summary
Screening for somatoforms symptoms (Rief, Hiller, 2003) and Illness Perception Questionnaire - Revised (Moss-Morris et al, 2002). Results: 2 (Groups) Â 2 (Time: Before / After) ANOVA with repeated measures revealed major effect of time with both groups demonstrated equal decrease in somatoform symptoms during treatment (F=101.42, p
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