Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité - University Medicine Berlin, Berlin, Germany.
PLoS One. 2012;7(12):e51167. doi: 10.1371/journal.pone.0051167. Epub 2012 Dec 5.
This prospective observational study investigated whether self-reported psychological distress and alcohol use problems of surgical patients change between preoperative baseline assessment and postoperative 6-month follow-up examination. Patients with preoperative interest in psychotherapy were compared with patients without interest in psychotherapy.
A total of 1,157 consecutive patients from various surgical fields completed a set of psychiatric questionnaires preoperatively and at 6 months postoperatively, including Patient Health Questionnaire-4 (PHQ-4), Brief Symptom Inventory (BSI), Center for Epidemiologic Studies Depression Scale (CES-D), World Health Organization 5-item Well-Being Index (WHO-5), and Alcohol Use Disorder Identification Test (AUDIT). Additionally, patients were asked for their interest in psychotherapy. Repeated measure ANCOVA was used for primary data analysis.
16.7% of the patients were interested in psychotherapy. Compared to uninterested patients, they showed consistently higher distress at both baseline and month 6 regarding all of the assessed psychological measures (p's between <0.001 and 0.003). At 6-month follow-up, neither substantial changes over time nor large time x group interactions were found. Results of ANCOVA's controlling for demographic variables were confirmed by analyses of frequencies of clinically significant distress.
In surgical patients with interest in psychotherapy, there is a remarkable persistence of elevated self-reported general psychological distress, depression, anxiety, and alcohol use disorder symptoms over 6 months. This suggests high and chronic psychiatric comorbidity and a clear need for psychotherapeutic and psychiatric treatment rather than transient worries posed by facing surgery.
本前瞻性观察研究旨在探讨手术患者的自我报告心理困扰和酒精使用问题是否在术前基线评估和术后 6 个月随访检查之间发生变化。比较了术前对心理治疗感兴趣的患者和对心理治疗不感兴趣的患者。
来自不同外科领域的 1157 名连续患者在术前和术后 6 个月完成了一套精神病学问卷，包括患者健康问卷-4（PHQ-4）、简明症状量表（BSI）、流行病学研究抑郁量表（CES-D）、世界卫生组织 5 项幸福感指数（WHO-5）和酒精使用障碍识别测试（AUDIT）。此外，还询问了患者对心理治疗的兴趣。主要数据分析采用重复测量方差分析。
16.7%的患者对心理治疗感兴趣。与不感兴趣的患者相比，他们在基线和第 6 个月时，所有评估的心理测量结果都表现出更高的困扰（p 值均小于 0.001 至 0.003）。在 6 个月的随访中，既没有发现随时间的显著变化，也没有发现大的时间 x 组交互作用。控制人口统计学变量的 ANCOVA 分析结果通过对临床显著困扰频率的分析得到了证实。
对心理治疗感兴趣的手术患者中，自我报告的一般心理困扰、抑郁、焦虑和酒精使用障碍症状在 6 个月内持续显著升高。这表明存在较高和慢性的精神共病，明确需要心理治疗和精神治疗，而不是手术带来的短暂担忧。
