Perioperative anxiety and depression in patients undergoing abdominal surgery for benign or malignant disease

Abstract

Background and Objectives Etiologies, levels, and associated factors of psychological distress in cancer patients facing surgery are poorly defined. We conducted a prospective comparative study of perioperative anxiety and depression in patients undergoing abdominal surgery for either malignant or benign disease. Methods With Institutional Review Board approval, patients consenting for surgery at our institution were enrolled. Surveys were completed at a preoperative visit and within 2 weeks of a postoperative appointment. Participants listed their top three sources of anxiety, and completed the Patient Health Questionnaire‐9 and the General Anxiety Disorder‐7. Results A total of 79 patients completed the preoperative assessment and 44 (58.7%) finished the postoperative survey. Forty‐one were male (51.9%), 12 (15.2%) had a psychiatric comorbidity (PSYHx), and 47 (59.5%) had cancer. Perioperative anxiety and depression did not differ by malignancy status. Patients were most concerned about surgery (22.5%) preoperatively and finances (27.9%) postoperatively. PSYHx, frailty, insurance status, and opioid use were all associated with perioperative psychological distress. Conclusions Cancer patients did not have significantly higher levels of perioperative psychological distress compared with benign controls. Socioeconomic worries are prevalent throughout the perioperative period, and efforts to alleviate distress should focus on providing adequate counseling.

Perceived Provision of Perioperative Information and Care by Patients Who Have Undergone Surgery for Colorectal Cancer: A Cross-Sectional Study

“…Almost one-third of patients did not receive information about whether surgical wait-time would impact cancer cure. Concerns about cancer quickly spreading and the urgency to have surgery are a key source of patient distress [ 33 , 34 ]. In Australia, most of the delay for treatment occurs at the diagnosis phase (52 days) rather than the interval after a positive diagnosis to surgery (30 days) [ 35 , 36 , 37 ].…”

Factors Predicting Prolonged Postoperative Ileus in Patients Undergoing Major Gastrointestinal Surgery

“…Several recent studies have addressed the problem of clinical anxiety in elective surgery. 30,[34][35][36] Preoperative anxiety in surgical patients develops for several reasons such as fear of complications, postoperative pain, disability, and death. 34,36 The association between psychological distress and changes in gastrointestinal function has been established in many studies.…”

“…30,[34][35][36] Preoperative anxiety in surgical patients develops for several reasons such as fear of complications, postoperative pain, disability, and death. 34,36 The association between psychological distress and changes in gastrointestinal function has been established in many studies. 37,38 It is known to alter autonomic innervation, specifically stimulated sympathetic innervation, which relaxes the smooth muscle, thus decreasing bowel motility.…”

How we assess the perioperative anxiety of surgical patients with pulmonary nodules: the revision of state-trait anxiety inventory

“…At the beginning of twenty-first century, the concept of enhanced recovery after surgery (ERAS) emphasizes the integrated application of various methods to enhance perioperative management and promote postoperative recovery of patients as well, including pain relief, minimally invasive operation, and so on [ 7 – 11 ]. The assessment and intervention of perioperative anxiety should also be a part, and it is getting more and more attention [ 12 – 16 ].…”