Preoperative Anxiety Symptoms Research Articles

Association Between Symptoms of Anxiety and Depression, Hip Pathology, and Patient-Reported Outcomes After Hip Arthroscopy for Femoroacetabular Impingement.

In patients with femoroacetabular impingement (FAI), mental health has been implicated in both symptom severity and postoperative outcomes. However, there are limited data regarding the independent influences of baseline mental health and hip pathology on patient-reported outcomes over time after hip arthroscopy. To evaluate the association between mental health and structural hip pathology with pain, hip function, and quality of life (QOL). Cohort study; Level of evidence, 3. Patient records from a single surgeon's hip outcomes registry were retrospectively reviewed. Mental health was evaluated using the Patient-Reported Outcomes Measurement Information System Anxiety and Depression scores. Pain was evaluated with the Single Assessment Numeric Evaluation score for Activities of Daily Living (SANE-ADL), while hip-related QOL was evaluated with the 12-item International Hip Outcome Tool (iHOT-12). Hip function was assessed with the Hip Outcome Score (HOS) Sport-Specific (SS) and ADL subscales. Separate mixed models were used to predict pain, QOL, and hip function, including hip pathology measures (size of labral tear, grade of chondral damage, preoperative alpha angle), anxiety, depression, and time as fixed effects and individuals as a random effect. A total of 312 patients were included in this study. The preoperative alpha angle, degree of intraoperative cartilage damage, and size of the labral tear were not associated with pain or QOL (P > .05 for all). However, higher levels of anxiety and depression were significantly associated with lower SANE-ADL scores (estimate ± SE) (anxiety: -0.59 ± 0.07, P < .0001; depression: -0.64 ± 0.08, P < .0001), iHOT-12 scores (anxiety: -0.72 ± 0.07, P < .0001; depression: -0.72 ± 0.08, P < .0001), HOS-SS scores (anxiety: -0.68 ± 0.09, P < .0001; depression: -0.57 ± 0.10, P < .0001), and HOS-ADL scores (anxiety: -0.43 ± 0.05, P < .0001; depression: -0.43 ± 0.06, P < .0001). Patients had similar improvements in pain scores, QOL, and hip function after hip arthroscopy for FAI irrespective of their degree of hip pathology. Additionally, preoperative symptoms of anxiety and depression symptoms were associated with greater pain, decreased QOL, and worse hip function both pre- and postoperatively, independent of the degree of hip pathology. This suggests that efforts to directly address symptoms of anxiety and depression may improve outcomes after hip arthroscopy.

Prevalence and factors associated with preoperative anxiety among patients undergoing surgery in low-income and middle-income countries: a systematic review and meta-analysis

ObjectivesThis review aimed to determine the pooled prevalence of preoperative anxiety and its associated factors among patients undergoing surgery in low/middle-income countries (LMICs).MethodsWe searched PubMed, SCOPUS, CINAHL, Embase and PsychINFO...

Correlation between preoperative psychological personality traits of glioma patients and psychological distress in their primary caregivers

ObjectiveTo explore the relationship between preoperative psychological personality traits of glioma patients and preoperative psychological distress of their primary caregivers. MethodsA retrospective analysis was conducted on 85 glioma patients (tumor group) who were admitted to our hospital from February 2016 to December 2018 and 85 primary caregivers. Forty-one healthy volunteers were used as controls. ResultsThe scores of 9 scales of the Minnesota Multiphasic Personality Inventory (MMPI) increased significantly in the tumor group compared to the healthy controls (P < 0.05), including L (lie): [(56.0 ± 11.5 vs. 50.0 ± 10.0)], F (fake): [(53.0 ± 10.6 vs. 41.7 ± 8.8)], Hs (hypochondriasis): [(55.6 ± 11.2 vs. 44.2 ± 8.3)], D (depressive personality): [(49.2 ± 9.6 vs. 42.2 ± 10.3)], Mf (masculinity-femininity): [(49.9 ± 9.4 vs. 42.8 ± 14.0)], Pt (psychasthenia): [(51.5 ± 10.0 vs. 40.9 ± 11.5)], Sc (schizophrenia): [(51.2 ± 10.6 vs. 40.2 ± 10.6)], Ma (hypomania): [(51.8 ± 9.1 vs. 47.7 ± 9.4)] and Si (social introversion): [(46.6 ± 8.7 vs. 36.7 ± 13.0)]. However, the K (defensive responses) scale score in the tumor group decreased significantly (52.1 ± 13.9 vs. 58.8 ± 12.1, P = 0.009). The F (fake): [(rs=0.253, P=0.019 / rs=0.215, P=0.048)], Hs (hypochondriasis): [(rs=0.310, P=0.004 / rs=0.345, P=0.001)], Pt (psychasthenia): [(rs=0.299, P=0.006 / rs=0.258, P=0.017)], and Sc (schizophrenia): [(rs=0.325,P=0.002/rs=0.322, P=0.003)] of preoperative glioma patients were positively correlated with their preoperative psychological distress (depression/anxiety); the D (depressive personality): [(rs=0.229, P=0.035)] of preoperative glioma patients was positively correlated with the preoperative depression symptoms of their primary caregivers, and the Hy (hysteria): [(rs=0.233, P=0.002)] and Pd (psychopathic deviate): [(rs=0.215, P=0.006)] of preoperative glioma patients were positively correlated with the preoperative anxiety symptoms of their primary caregivers. ConclusionsThe preoperative psychological personality traits of glioma patients were positively correlated with preoperative symptoms of depression and anxiety in primary caregivers.

Functional somatic symptoms in young people in general practice: Prevalence, clinical management and GP-experienced burden

To address the effect of preoperative symptoms of depression and anxiety on headache and low back pain after spinal anesthesia.This prospective observational cohort study included 370 patients who underwent spinal anesthesia before elective surgeries at a university hospital. The patients were evaluated in terms of symptoms of depression (Beck Depression Inventory) and anxiety (Beck Anxiety Scale) while in their wards. The patients were evaluated via telephone calls for headache and low back pain after the operation.Eighty-two (82/362) (23%) patients were determined as having headache and 28 (28/362) (7.8%) were determined as having low back pain. There was a significant association between preoperative depression scores and anxiety scores and VAS scores of headache (respectively, eta-squared = 0.19, p < .001; eta-squared = 0.14, p < .001). There was a significant association between preoperative depression scores and anxiety scores and VAS scores of low back pain (respectively, eta-squared = 0.02, p = .08; eta-squared = 0.03, p = .01).Preoperative symptoms of anxiety and symptoms of depression affect headache after spinal anesthesia. Preoperative symptoms of depression affect acute low back pain after spinal anesthesia.This trial was also registered at http://www.ClinicalTrials.gov. (Protocol Registration Receipt NCT03427372).

Associations of Preoperative Self-rated Symptoms of Anxiety and Depression on Length of Hospital Stay and Long-term Quality of Life in Patients Undergoing Cardiac Surgery.

Anxiety and depression are often associated with cardiovascular diseases. Nevertheless, few study authors have investigated psychological effects on immediate and long-term cardiac surgery-related outcomes, such as surgical complications, length of hospital stay (LOS), and long-term health-related quality of life (HRQoL). The aims of this study were to (a) investigate the role of preoperative symptoms of anxiety and depression in predicting LOS in a sample of surgical patients and (b) evaluate the impact of preoperative symptoms of anxiety and depression on the patients' HRQoL 3 months after surgery. One hundred fifty-one patients waiting for surgery were included. To evaluate symptoms of anxiety and depression, the Hospital Anxiety and Depression Scale was used. Multiple regression analyses were conducted to evaluate the impact of both clinical and psychological factors on LOS, whereas quantile regression was performed to assess their effect on the patients' HRQoL 3 months after surgery. The multiple regression shows that EuroSCORE, length of endotracheal intubation, and anxiety symptoms predict LOS. The multiple quantile regression analyses also show that both symptoms of anxiety and depression predict a negative HRQoL up to 3 months after surgery. Preoperative symptoms of anxiety predict the patients' LOS, and both symptoms of anxiety and depression predict a scarce HRQoL 3 months after cardiac surgery. These results suggest the need for implementing presurgical in-hospital screening procedures for both symptoms of anxiety and depression. Finally, focused psychological interventions should be implemented for reducing inpatients' hospital LOS and improving their future quality of life.

Clinical study of preoperative psychological distress and its related factors in the primary caregivers of patients with glioma

ObjectiveTo investigate the preoperative psychological distress in the primary caregivers of glioma patients and its influencing factors and to determine the relationship between preoperative psychological states of glioma patients and their caregivers. MethodsUsing a mixed methods design, the caregivers of patients with malignant glioma were interviewed and completed questionnaires about anxiety/depression and family function during preoperative period. ResultsCaregivers of glioma patients had different types of psychological distress before surgery. A total of 46 caregivers (36.5 %) had preoperative psychological depression or anxiety symptom; 30 caregivers (23.8 %) had depression symptoms, 39 caregivers (31.0 %) had anxiety symptoms, and 23 (18.3 %) had both preoperative anxiety and depression symptoms. Female gender was an influential factor for both preoperative depression and anxiety symptoms in caregivers, surgical information was a risk factor for caregivers' preoperative depression symptoms and residence was a risk factor for caregivers' preoperative anxiety symptoms. The preoperative psychological states of patients was positively correlated with the preoperative anxiety and depression symptoms of caregivers. ConclusionThe rural female caregivers are more likely to experience psychological distress before surgery, and the preoperative psychological states of patients was positively correlated with the psychological distress in caregivers.

Primary sialorrhea and its surgical treatment with denervation of the submandibular glands in combination with sublingual gland excision

ObjectivesThe purpose of this study was to evaluate the effectiveness of ablating postganglionic parasympathetic fibers of the submandibular ganglion in combination with sublingual gland excision in the treatment of primary sialorrhea. Materials and methodsHealthy volunteers were initially chosen to determine a basic saliva flow rate value by saliva collection. Next, unstimulated and stimulated saliva flow rates, and a visual analog scale index for sialorrhea were recorded in all the patients pre- and postoperatively. In addition, the generalized anxiety disorder scale was used to assess preoperative anxiety symptoms. The follow-up durations ranged from 24 to 36 months after surgery. ResultsA total of 10 patients were included in this study. Preoperatively, the mean unstimulated saliva flow rate for the 10 patients was 11.26 ± 4.19 ml/10 min, the stimulated saliva flow rate was 16.76 ± 3.49 ml/6 min, and the visual analog scale index was 66.29 ± 14.86. Postoperatively, the mean unstimulated and stimulated saliva flow rates were significantly reduced to 5.99 ± 1.33 ml/10 min (p = 0.001) and 13.28 ± 1.86 ml/6 min (p = 0.013), respectively, and the visual analog scale index was 25.41 ± 5.6 (p < 0.001). No complications were found after operation. ConclusionThis study demonstrates that ablation of postganglionic parasympathetic fibers of the submandibular ganglion in combination with sublingual gland excision by an intraoral approach is a simple, safe, and efficient approach for treating primary sialorrhea.

Preoperative anxiety in children undergoing elective circumcision: A cross-sectional study in a training and research hospital

Aim: Limited research has been conducted regarding the symptoms of preoperative anxiety that children exhibit prior to circumcision. The aim of this study is to determine the frequency of preoperative anxiety symptoms in children preparing for circumcision and the associated factors.Materials and Methods: This cross-sectional study included 62 subjects ranging from ages 2-12. A personal information form, which the research team developed, was used to evaluate the socio-demographic and clinical data of the participants. Symptoms of preoperative anxiety were assessed using the modified Yale Preoperative Anxiety Scale.Results: The mean age of the participants was 7.37±2.97 and m-YPAS scores were 56±18.10. Increased preoperative anxiety symptoms were observed in 82.3% (n=51) of circumcised children. Subjects who engaged in certain activities prior to admission exhibited significantly lower m-YPAS scores compared to those who did not (p0.05).Conclusions: The early recognition and management of preoperative anxiety in children expecting circumcision will help clinicians in preventing the potential complications associated with increased preoperative anxiety.

Ansiedade e depressão pré-operatória: diferenças entre pacientes submetidos à primeira cirurgia cardíaca

Objetivo: comparar os sintomas pré-operatórios de ansiedade e depressão entre pacientes submetidos à primeira cirurgia cardíaca. Métodos: estudo observacional, analítico, de corte transversal. Uma amostra consecutiva e não probabilística foi constituída por pacientes submetidos às cirurgias cardíacas eletivas, sem descompensação clínica no dia da entrevista. Para avaliação dos sintomas de ansiedade e depressão foi utilizado o Hospital Anxiety and Depression Scale. A comparação dos sintomas foi realizada com o teste de Mann-Whitney, α=5,0%. Resultados: participaram do estudo 80 pacientes submetidos à primeira cirurgia e 19 à reoperação. Pacientes da primeira cirurgia apresentaram mediana de seis e os reoperados de quatro na medida de depressão (p=0,107). Nos sintomas de ansiedade, pacientes da primeira cirurgia apresentaram a mediana de oito e os reoperados de seis (p=0,171). Conclusão: os escores de ansiedade e depressão foram maiores entre os pacientes submetidos à primeira cirurgia, mas não foi encontrada diferença estatisticamente significativa entre os grupos.

Preoperative anxiety and depression: differences among patients submitted to the first cardiac surgery

Objective: to compare the preoperative symptoms of anxiety and depression among patients submitted to the first cardiac surgery. Methods: observational, analytic and cross-sectional study. A consecutive and non-probabilistic sample consisted of patients submitted to elective cardiac surgeries, without clinical decompensation on the day of the interview. To assess the anxiety and depression symptoms, the Hospital Anxiety and Depression Scale was used. The symptoms were compared by means of the Mann-Whitney test, α=5.0%. Results: the study participants were 80 patients submitted to the first surgery and 19 to reoperation. Patients in their first surgery presented a median score of six and reoperated patients a median score of four on the depression scale (p=0.107). Concerning the anxiety symptoms, patients in their first surgery presented a median score of eight, against six for the reoperated patients (p=0.171). Conclusion: the anxiety and depression scores were higher among the patients submitted to their first surgery, but no statistically significant difference was found between the groups.

Symptoms of depression and anxiety and 11-year all-cause mortality in men and women undergoing coronary artery bypass graft (CABG) surgery

ObjectivesTo investigate the overall and the sex-specific association of preoperative and one-year post coronary artery bypass (CABG) surgery symptoms of depression and anxiety with 11-year all-cause mortality. MethodsA multicenter prospective study including 1125 patients who completed the Hospital Anxiety and Depression Scale (HADS) before an elective CABG surgery, of whom 850 completed the HADS again at one-year follow-up. Information on all-cause mortality was obtained through the Israeli Ministry of Internal Affairs Register. Multivariable adjusted Cox regression models quantified the association of symptoms of depression and anxiety with all-cause mortality. ResultsFemales comprised 22.7% of the cohort and were 5.5years older than males (70.0±9.3 and 64.4±10.3years, respectively). Controlling for sociodemographic and lifestyle factors, illness severity and post-surgery participation in cardiac rehabilitation, there was little evidence of an association between preoperative symptoms of depression and mortality in males [adjusted hazard ratio (aHRmales)=1.03, 95% CI 0.99–1.07, p=0.21] or females (aHRfemales=1.01, 95% CI 0.95–1.08, p=0.7). One-year postoperative symptoms of depression were associated with mortality in both males (aHRmales=1.05, 95% CI 1.01–1.10, p=0.03) and females (aHRfemales=1.07, 95% CI 1.02–1.13, p=0.013). Preoperative symptoms of anxiety were unrelated to mortality overall, but among females postoperative symptoms of anxiety predicted 11-year mortality (aHRfemales=1.07, 95% CI 1.00–1.14, p=0.049). There was no HADS by sex interaction (p for interaction=0.12–0.99). ConclusionsSymptoms of depression one-year after surgery were positively related to mortality with little evidence for sex differences. These findings underscore the need for identification and treatment of psychiatric symptoms in patients undergoing CABG surgery.Clinical Trial Registration: ClinicalTrials.gov: NCT00356863

Postoperative Pain and Subsequent Ptsd-Related Symptoms in Patients Undergoing Lung Resection for Suspected Cancer

Because lung cancer resection is at the crossroad between cancer and high-risk surgery, we hypothesized that the patients undergoing lung resection for cancer are exposed to develop a post-traumatic stress disorder (PTSD) syndrome-related symptoms. Forty-seven adult patients were included in the study. Patients were eligible for inclusion if they underwent lung resection for suspected cancer, if they were able to speak and read French, and if they agreed to be reached for a telephone interview. We assessed before, immediately after, and 3 months after surgery the presence of symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) and PTSD-related symptoms (impact of events scale revised [IES-R]). At the 3-month assessment, an IES-R score > 22 was used as criteria for predicting the patients at risk of PTSD-related symptoms. We identified an IES-R score higher than 22 in 24 participants (51%). Patients with a preoperatory Hospital Anxiety and Depression Scale(anxiety) score more than 7 (T0) and a maximal visual analogic scale score more than 40 during the first 24 hours after surgery were more likely to develop PTSD-related symptoms at 3-months with odd ratios at 4.61 [1.20-17.73] (p = 0.03) and 1.34 [1.05-1.75] (p = 0.02). The prevalence of PTSD-related symptoms after lung cancer resection is high, showing that lung cancer patients undergoing surgical resection are at high risk of postprocedure burden. The presence of preoperative symptoms of anxiety and acute procedural pain during the early postoperative period are strong predictors for developing PTSD-related symptoms after lung cancer surgery.

Anxiety and depression as risk factors for mortality after coronary artery bypass surgery

Objective This retrospective study examined the association between symptoms of depression, anxiety, and mortality risk following coronary artery bypass graft (CABG) surgery. Methods We assessed 440 CABG surgery patients' scores on the Depression Anxiety and Stress Scale (DASS) and followed up mortality status for a median of 5 years, 10 months. Results There were 67 (15%) deaths overall during the follow-up period. Adjusted survival analysis showed that preoperative depressive symptoms were not associated with a significantly higher risk of mortality. Survival analysis with preoperative anxiety adjusted for covariates showed a significantly increased mortality risk [hazard ratio (HR)=1.88 (95% CI=1.12–3.17), P=.02]. Conclusion Preoperative anxiety symptoms were significantly associated with increased mortality risk after adjustment for known mortality risk factors. Future research should further explore the simultaneous role of anxiety and depression on mortality following CABG.