Psychological Distress Before and After Surgical Resection of Benign Orofacial Tumors: A Prospective Study

Abstract

We evaluated the presence and level of psychological distress in patients before and after resection of benign orofacial tumors and identified the variables associated with this psychological distress. The present study used the Hospital Anxiety and Depression Scale and the Rosenberg Self-Esteem Scale. A questionnaire that included these 2 scales was administered to the patients before surgery and at 1, 2, and 6weeks after surgery. The scores at the various intervals were statistically compared, and the relationships between the variables (eg, age, gender, education, marital status, occupation, lesion size) and psychological distress were also tested. Of the 31 patients, 29% had abnormal levels of anxiety before surgery, and 12.9% reported abnormal depression levels before surgery. The proportion of patients with abnormal anxiety levels increased from 29% before surgery to 38.7, 38.7, and 35.5% at 1, 2, and 6weeks after surgery, respectively. The proportion of patients with abnormal depression levels at all intervals after surgery remained the same as that before surgery (12.9%). All the patients had normal self-esteem levels both before and after surgery. Using a paired t test, the mean anxiety scores at all intervals after surgery were significantly greater than the mean anxiety score before surgery. Analyses of the relationships between the independent variables and psychological distress (anxiety and depression) found the level of education to be significantly associated with anxiety before and after surgery. In contrast, the lesion size was significantly associated with depression both before and after surgery. The results of the present study suggest that abnormal anxiety and depression will be present in some patients with benign orofacial tumors both before and after surgery. The patients' education level and lesion size were strongly associated with the level of psychological distress present in patients with benign orofacial tumors.