scholarly journals Anxiety and Depression Affect Early Postoperative Pain Dimensions after Bariatric Surgery

2020 ◽  
Vol 10 (1) ◽  
pp. 53
Author(s):  
Sofia Gravani ◽  
Maria Matiatou ◽  
Pantelis T. Nikolaidis ◽  
Evangelos Menenakos ◽  
Constantinos G. Zografos ◽  
...  

Uncontrolled postoperative pain and prolonged immobilization after bariatric surgery have been associated with increased postoperative complications and prolonged hospitalization. The aim of our study was to evaluate the postoperative pain that follows bariatric surgery and identify any psychological factors that may affect the early postoperative perception of pain. The study included 100 patients with obesity (women, n = 61; age 37.4 ± 9.9 years, mean ± standard deviation; Body Mass Index (BMI) 47.6 ± 6.5 kg/m2) who underwent bariatric surgery. Preoperative anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale (HADS), and the quantitative and qualitative dimension of early postoperative pain were evaluated by the McGill Pain Questionnaire Short Form (MPQ-SF). Furthermore, the postoperative analgesia protocol was recorded for each patient. Pain declined gradually during the first 24 h postoperative. Although preoperative anxiety had no correlation with the overall pain of postoperative Day 0, patients with a higher level of preoperative anxiety had significantly more intense and more unpleasant pain at 1 h post operation. In addition, depression influences both the intensity and unpleasantness of pain at different time points (1 h, 4 h and 24 h postoperative). Preoperative pain correlated with educational level, but not with age, BMI, gender, marital status, smoking and surgery type. In conclusion, preoperative anxiety and depression influence the early postoperative pain after bariatric surgery, and their preoperative identification is of major importance to enhance the implementation of fast-track postoperative protocols to prevent complications and prolonged hospitalization.

2020 ◽  
Vol 15 (2) ◽  
pp. 217-225
Author(s):  
Sehun Lim ◽  
Younmi Oh ◽  
Kwangrae Cho ◽  
Myoung-hun Kim ◽  
Sungho Moon ◽  
...  

Background: Higher levels of anxiety increase the risks of surgery, including morbidity and mortality. The objectives of this study were to measure anxiety and depression during the preoperative period and to identify the degree of knowledge and concerns of older patients and their family protectors regarding anesthesia, and the causes of these concerns. Methods: We administered a questionnaire to older patients scheduled to undergo surgery and their family protectors one day prior to the surgery. The questionnaire included tools for quantifying anxiety and depression (Anxiety-Visual Analogue Scale, the Amsterdam Preoperative Anxiety and Information Scale, State-Trait Anxiety Inventory Korean YZ Form, and Short Form Geriatric Depression Scale). We also asked about the concrete causes of anxiety using pre-created forms.Results: There were 140 older patients and family protectors who participated in the study. The majority of older patients (n = 114, 81.4%) undergoing surgery and their family protectors (n = 114, 81.4%) indicated that they were anxious. Most of the older patients and their family protectors responded that they had insufficient knowledge about anesthesia, and they were mostly worried about failure to awaken following surgery, and postoperative pain. Older patients with higher anxiety scores showed higher depression scores. There were significant differences in depression scores depending on the presence of cohabitating family members. Conclusions: It is important to remember that older patients with higher depression scores have higher anxiety during the preoperative period.


2021 ◽  
Vol 15 (4) ◽  
pp. 484-494
Author(s):  
Dennis Boye Larsen ◽  
Mogens Laursen ◽  
Ole Simonsen ◽  
Lars Arendt-Nielsen ◽  
Kristian Kjær Petersen

Background: Chronic postoperative pain following total joint replacement (TJA) is a substantial clinical problem, and poor sleep may affect predictive factors for postoperative pain, such as pain catastrophizing. However, the magnitude of these associations is currently unknown. This exploratory study investigated (1) the relationship between preoperative sleep quality, clinical pain intensity, pain catastrophizing, anxiety, and depression and (2) their associations with chronic postoperative pain following TJA. Methods: This secondary analysis from a larger randomized controlled trial included rest pain intensity (preoperative and 12 months postoperative; visual analogue scale, VAS), preoperative Pittsburgh Sleep Quality Index (PSQI), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS) data from 74 knee and 89 hip osteoarthritis (OA) patients scheduled for TJA. Poor sleepers were identified based on preoperative PSQI scores higher than 5. Results: Poor sleepers demonstrated higher preoperative VAS, pain catastrophizing, anxiety, and depression compared with good sleepers (all p < 0.003). Preoperative PSQI (β = 0.23, p = 0.006), PCS (β = 0.44, p < 0.005), and anxiety (β = 0.18, p = 0.036) were independent factors for preoperative VAS. Preoperative VAS (β = 0.32, p < 0.005), but not preoperative sleep quality (β = −0.06, p = 0.5), was an independent factor for postoperative VAS. Conclusion: The OA patients reporting poor preoperative sleep quality show higher preoperative pain, pain catastrophizing, anxiety, and depression. High preoperative pain intensity, but not poor sleep quality, was associated with higher chronic postoperative pain intensity. Future studies are encouraged to explore associations between sleep and chronic postoperative pain.


2005 ◽  
Vol 11 (3) ◽  
pp. 322-327 ◽  
Author(s):  
Lorraine V Kalia ◽  
Paul W OConnor

Introduction: This study used reliable and validated instruments to compare pain severity in multiple sclerosis (MS) to that in other chronic painful conditions, and to examine relationships between chronic pain in MS and health-related quality of life (HRQOL). Methods: Ninety-nine MS patients completed a self-administered survey comprised of the Medical Outcomes 36-Item Short-Form Health Survey, the Short-Form McGill Pain Questionnaire, and the Hospital Anxiety and Depression Scale. Results: Pain severity was not different between MS patients with pain and rheumatoid arthritis (P=0.77) or osteoarthritis (P=0.98) patients. Chronic pain in MS was less often neurogenic than non-neurogenic, although severity of neurogenic pain was greater than that of non-neurogenic pain (P=0.048). Chronic pain in MS was found to have no significant relationship to age, disease duration or disease course. Instead, we found that pain was correlated with aspects of HRQOL, particularly mental health (r=0.44, P<0.0001) versus physical functioning (r=0.19, P>0.05). Chronic pain was significantly related to anxiety and depression for females but not for males with MS. Conclusions: Chronic pain in MS is as severe as pain in arthritic conditions and is associated with reduced HRQOL. Thus, pain can be a significant symptom for MS patients and the need for treatment may be underestimated.


Author(s):  
Carlos Alberto Henao Periañez ◽  
Marcio Alexander Castillo Diaz ◽  
Priscila Lara Vieira Bonisson ◽  
Giovana Paula Rezende Simino ◽  
Maria Helena Barbosa ◽  
...  

ABSTRACT Objectiv:e to analyze the relationship of anxiety and depression in the preoperative period with the presence of pain in the postoperative period. Method: cohort study conducted at a university hospital in the state of Minas Gerais (Brazil), between february and July 2017, with 65 patients. A collection instrument was elaborated for the demographic and clinical characteristics. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression; pain intensity was measured using the Verbal Numerical Scale. Data were submitted to descriptive and inferential statistical analysis. Results: according to demographic and clinical characteristics, most patients were female, with a median age of 44 years and surgical specialty of the digestive tract. In the preoperative period, 31 (47.7%) had anxiety, and nine (13.8%), depression. None of the patients reported pain immediately prior to surgery. The incidence of moderate to severe postoperative pain was 32 (49.2%) patients. There was a statistically significant difference in the distribution of patients with postoperative pain in relation to the presence or absence of preoperative anxiety (p value <0.001). There is no statistically significant difference in the distribution of patients with postoperative pain in relation to the presence or absence of preoperative depression (0.733). In multivariate analysis, preoperative anxiety was a predictive factor for postoperative pain. Depression was not a predictive factor of postoperative pain. Conclusion: It was demonstrated that, regardless of the demographic and clinical characteristics of the studied sample, the presence of anxiety in patients in the preoperative period is a predictive factor of postoperative pain.


2008 ◽  
Vol 29 (11) ◽  
pp. 1063-1068 ◽  
Author(s):  
Loretta B. Chou ◽  
Dominic Wagner ◽  
Daniela M. Witten ◽  
Gabriel J. Martinez-Diaz ◽  
Nancy S. Brook ◽  
...  

Background: Orthopaedic procedures have been reported to have the highest incidence of pain compared to other types of operations. There are limited studies in the literature that investigate postoperative pain. Materials and Methods: A prospective study of 98 patients undergoing orthopedic foot and ankle operations was undertaken to evaluate their pain experience. A Short-Form McGill Pain Questionnaire (SF-MPQ) was administered preoperatively and postoperatively. Results: The results showed that patients who experienced pain before the operation anticipated feeling higher pain intensity immediately postoperatively. Patients, on average, experienced higher pain intensity 3 days after the operation than anticipated. The postoperative pain intensity at 3 days was the most severe, while postoperative pain intensity at 6 weeks was the least severe. Age, gender and preoperative diagnosis (acute versus chronic) did not have a significant effect on the severity of pain that patients experienced. Six weeks following the operation, the majority of patients felt no pain. In addition, the severity of preoperative pain was highly predictive of their anticipated postoperative pain and 6-week postoperative pain, and both preoperative pain and anticipated pain predict higher immediate postoperative pain. Conclusion: The intensity of patients' preoperative pain was predictive of the anticipated postoperative pain. Patients' preoperative pain and anticipated postoperative pain were independently predictive of the 3-day postoperative pain. The higher pain intensity a patient experienced preoperatively suggested that their postoperative pain severity would be greater. Therefore, surgeons should be aware of these findings when treating postoperative pain after orthopaedic foot and ankle operations. Level of Evidence: II, Prospective Comparative Study


2021 ◽  
Author(s):  
Umberto Albert ◽  
Pasquale Losurdo ◽  
Alessia Leschiutta ◽  
Serena Macchi ◽  
Natasa Samardzic ◽  
...  

Abstract Purpose On January 30, 2020, the World Health Organization declared COVID-19 as a “public health emergency of international concern.” The primary aim of the study was to evaluate weight and food habit changes during COVID-19 outbreak. The secondary endpoint was to explore the psychological factors, arising during the pandemic, influencing weight and dietary variations. Materials and Methods A survey composed of four different items was conducted by telephone interview: (1) anthropometric data and type of procedure, (2) Hospital Anxiety and Depression Scale (HADS), (3) maladaptive eating behaviors, and (4) personal feelings moved by the COVID-19 spread and lockdown. Results Fifty-six patients were enrolled. No significant changes in weight, BMI, and maladaptive eating habits were observed. A significant reduction in the anxiety index score was observed. In 17.8% of cases, a change in obesity class was reported, and among these patients, a substantial modification in bariatric procedures was planned (60%). Conclusion This study showed no effect on weight and BMI nor on rates of maladaptive eating habits associated with quarantine/social isolation among severely obese individuals waiting for the bariatric surgery. At the end of lockdown, a considerable proportion of patients modified their initial obesity class, and in selected cases, it could represent a criteria for rearrangement of the planned bariatric procedure. In obese patients, the lockdown and social distancing generated a reduction of fear of confronting and being negatively judged by others. This psychological aspect was assessed with the reduction of the HADS score.


2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Manuel González-Panzano ◽  
Luis Borao ◽  
Paola Herrera-Mercadal ◽  
Daniel Campos ◽  
Yolanda López-del-Hoyo ◽  
...  

Abstract: Mindfulness and social cognition skills in the prediction of affective symptomatology in schizophrenia, obsessive-compulsive disorder and nonclinical participants. The aim of the study was to investigate significant predictors of affective symptomatology in schizophrenia, obsessive-compulsive disorder and healthy controls. The sample was of 91 participants who completed the following instruments: the Eye Test (emotional recognition), the Hinting Task (theory of mind), the Ambiguous Intentions and Hostility Questionnaire(AIHQ; attributional style), Interpersonal Reactivity Index (IRI; empathy), the Mindful Attention Awareness Scale (MAAS; mindfulness trait), the Five Facet Mindfulness Questionnaire-Short Form(FFMQ-SF), and the Hospital Anxiety and Depression Scale(HADS). Significant predictors of affective symptomatology were: mindfulness (dispositional or trait mindfulness, nonreactivity and nonjudgment), and social cognition (SC) (attributional style and theory of mind). Mediation analysis showed that theory of mind was the only significant mediator of affective symptomatology. This paper shows the role of mindfulness and SC skills in the prediction of affective symptomatology.Keywords: mindfulness, social cognition, theory of mind, affective symptomatology, schizophrenia, obsessive-compulsive disorder.Resumen:El objetivo del estudio fue investigar predictores significativos de sintomatología afectiva en Esquizofrenia (EZ), trastorno obsesivo compulsivo (TOC) y controles no clínicos. La muestra fue de 91 participantes que completaron los siguientes instrumentos: Eyes Test (reconocimiento emocional), Hinting Task (teoría de la mente), Ambiguous Intentions and Hostility Questionnaire (AIHQ; estilo atribucional), Índice de Reactividad Interpersonal (IRI; empatía), Mindful Attention Awareness Scale (MAAS;mindfulness rasgo), Five Facet Mindfulness Questionnaire-Short Form (FFMQ-SF), y Hospital Anxiety and Depression Scale (HADS).Los resultados mostraron que el mindfulness (mindfulness rasgo, no reactividad y no juicio) y la cognición social (estilo atribucional y teoría de la mente) fueron predictores significativos. Los análisis de mediación señalaron la variable de teoría de la mente, como único mediador significativo de la sintomatología afectiva.Los resultados de este estudio señalan el papel de las habilidades de mindfulness y cognición social en la predicción de sintomatología afectiva.Palabras clave: mindfulness, cognición social, teoría de la mente, sintomatología afectiva, esquizofrenia, trastorno obsesivo-compulsivo.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S25-S25
Author(s):  
Jonathan Gibb ◽  
Chris Rogers ◽  
Eleanor Gidman ◽  
Graziella Mazza ◽  
Jane Blazeby ◽  
...  

AimsTo determine the prevalence of anxiety and depression amongst participants with severe or complex obesity randomised and selected for bariatric surgery in a large multi-centre trial.To describe the change in prevalence of anxiety and depression amongst participants who had undergone bariatric surgery, within 6 months of randomisation and at 12 months post-randomisation.MethodThe By-Band-Sleeve (BBS) study is a multi-site randomised controlled trial evaluating the surgical management of severe or complex obesity and is the largest trial of its kind. Participants completed the Hospital Anxiety and Depression Scale (HADS) on study enrolment (pre-randomisation) and at 12 months post-randomisation. In this sub-study, we describe provisional data concerning the baseline prevalence of anxiety and depression along with change in median HADS symptom score amongst those who actually underwent bariatric surgery.Result758 participants met the criteria for study inclusion with 716 (94.46%) and 712 (93.93%) individuals fully completing questionnaires for HADS-A and HADS-D. At pre-randomisation, the prevalence of possible (HADS A/D = 8-10) and probable (HADS A/D >11) anxiety or depression was 46.19% (n 330/716) and 48.17% (n 48.17%) respectively. Paired and complete HADS-A and HADS-D questionnaires were available for 70.25% (n 503/716) and 69.94% (n 498/712) participants. There was a highly statistically significant decrease in median HADS-A and HADS-D scores at 12 months post-randomisation (Wilcoxon signed-rank test p < 0.001). This was coupled with a statistically significant reduction in the proportion of cases with possible and probable anxiety (–9.54%, p < 0.001) and also depression (–22.21%, p < 0.001) at 12 months post-randomisation.ConclusionOur results characterise the high rate of psychological comorbidity amongst patients with severe or complex obesity selected for bariatric surgery. Whilst bariatric surgery remains the most clinically effective treatment for severe obesity, its effects on long-term post-operative mental health outcomes are less clear. These findings contribute to the growing body of evidence calling for increased pre/post-operative mental health surveillance and integrated care for this cohort of patients.


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