Shoar Saeed, Naderan Mohammad, Aghajani Motahareh, Sahimi-Izadian Elaheh, Hosseini-Araghi Negin, Khorgami Zhamak
Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Improvement of Surgical Outcomes and Procedures, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Oman Med J. 2016 May;31(3):176-81. doi: 10.5001/omj.2016.35.
Mood disorders are prevalent in hospitalized patients. However, risk factors for early diagnosis have not been studied exclusively in surgical patients. Our study aimed to investigate the prevalence and determinants of depression and anxiety symptoms in surgical patients.
We included 392 surgical patients in this prospective cross-sectional study, which took place between June 2011 and June 2012. The Hospital Anxiety and Depression Scale (HADS) was used to screen for symptoms of depression and anxiety at weekly interviews. Regression analysis was performed to identify risk factors for early (the day after admission) and late (one week or more) in-hospital psychiatry symptoms.
Depression and anxiety symptoms increased from the time of admission toward longer hospital stay. Scores obtained in the second and third weeks of admission were associated with the need for surgery while HADS in the third week was associated with lack of familial support and being under the poverty line (p < 0.050). Regression model analysis showed that early depression was associated with female gender, and early anxiety was inversely affected by female gender and protected by higher education level. A history of mood disorder was a risk factor. Later anxiety was also associated with longer hospital stay.
Depression and anxiety symptoms are a major concern in surgical patients especially in females and those with a history of mood disorders or lower educational level. Patients with a longer hospital stay, in particular, those with underlying diseases, postoperative complications, lack of familial support, and the need for reoperation were also at increased risk.
情绪障碍在住院患者中很常见。然而,早期诊断的危险因素尚未在外科患者中专门研究过。我们的研究旨在调查外科患者中抑郁和焦虑症状的患病率及决定因素。
我们纳入了392例外科患者进行这项前瞻性横断面研究,研究于2011年6月至2012年6月进行。采用医院焦虑抑郁量表(HADS)在每周的访谈中筛查抑郁和焦虑症状。进行回归分析以确定早期(入院后第二天)和晚期(一周或更长时间)住院精神症状的危险因素。
从入院时起,抑郁和焦虑症状随着住院时间延长而增加。入院第二周和第三周获得的分数与手术需求相关,而第三周的HADS分数与缺乏家庭支持和处于贫困线以下相关(p<0.050)。回归模型分析表明,早期抑郁与女性性别相关,早期焦虑受到女性性别的反向影响,并受到较高教育水平的保护。情绪障碍病史是一个危险因素。后期焦虑也与住院时间延长有关。
抑郁和焦虑症状是外科患者的主要关注点,尤其是女性以及有情绪障碍病史或教育水平较低的患者。住院时间较长的患者,特别是那些有基础疾病、术后并发症、缺乏家庭支持以及需要再次手术的患者,风险也增加。