Health status, anxiety, and depressive symptoms following complicated and uncomplicated colorectal surgeries.

PURPOSE

The purpose of this study was to evaluate the impact of complications following colorectal surgery on anxiety, depressive symptoms, and health status. Previously, very few studies examined the psychological impact of complications following colorectal surgery. Also, in clinical practice, little attention is paid to the psychological impact of complications.

METHODS

Patients undergoing colorectal surgery were evaluated prospectively preoperatively and postoperatively at 3 days, 6 weeks, and 1 year, using the Center for Epidemiological Studies-Depression (CES-D), State-Trait Anxiety Inventory (STAI), and Short Form 36 (SF-36) questionnaires. Patient data and complications were prospectively recorded. Postoperative CES-D, STAI, and SF-36 scores in patients with minor and severe complications were compared to scores of patients without complications using a general linear model.

RESULTS

Of 218 patients, 130 (59.6%) had complications. Colorectal surgery significantly increased depressive symptoms and anxiety levels in the same amount in all patient subgroups. Furthermore, it also lowered all domains of health status in all patient subgroups, but not equally. Patients with a severely complicated postoperative course had a larger postoperative decrease in health status, most notably at 6 weeks postoperatively with the largest effects in the physical-, mental-, social-, and vitality domains compared with the other subgroups.

CONCLUSIONS

Colorectal surgery has a profound effect on depressive and anxiety symptoms, as well as nearly all domains of health status. Occurrence of severe complications increases the negative effect of colorectal surgery on most domains of health status but do not specifically increase depressive symptoms or anxiety levels. At 6 weeks, these effects are most notable, but at 1 year, they have faded.