Journal article
Psychiatric distress amplifies symptoms after surgery for chronic rhinosinusitis
Otolaryngology-head and neck surgery, Vol.132(2), pp.189-196
02/2005
DOI: 10.1016/j.otohns.2004.09.135
PMID: 15692525
Abstract
BACKGROUNDPsychiatric disorders are associated with increased symptom burden when combined with chronic medical conditions. However, there are no reports of how psychiatric distress influences outcomes with surgical treatment for chronic rhinosinusitis (CRS). We hypothesized that subjects with psychiatric distress (somatization, anxiety, and depression) would report more severe long‐term sinus symptoms and worse quality of life (QOL) than subjects without psychiatric distress.
METHODSThis is a community‐based, prospective, observational cohort study of patients diagnosed with CRS presenting for surgery. Patients were interviewed before surgery; CT scans were reviewed, and questionnaires were completed about sinusitis‐related symptoms (SNOT‐16), general health status and QOL (SF‐36), and psychiatric distress (BSI and PHQ). Outcomes were also assessed 1, 3, 6, and 12 months postoperatively.
RESULTSNinety‐five patients had complete records for analysis. Psychiatric distress was prevalent, with 31% screening positive for somatization, 17% positive for anxiety, and 25% positive for depressive disorders. Subjects with somatization had significantly worse SNOT‐16 scores at each time point compared with those without somatization (P < 0.05). Subjects with depression reported more severe symptoms at 6 and 12 months after surgery than those without depression (P < 0.05). The presence of somatization preoperatively was also independently associated with worse symptom severity 12‐months after surgery, even after adjusting for prior sinus surgery, CT stage, Charlson Index, and deviated septum. In addition, subjects with psychiatric distress reported significantly worse SF‐36 physical and mental component summary scores 12‐months after surgery than subjects without psychiatric distress.
CONCLUSIONSPsychiatric distress is associated with worse reported sinus symptoms and lower QOL throughout surgical management of chronic rhinosinusitis. Despite this, subjects with psychiatric distress report a similar degree of improvement in sinus symptoms after surgery compared with those without distress.
CLINICAL SIGNIFICANCEPsychiatric distress should be considered in patients with persistent symptoms after surgery. Psychiatric distress should also be considered in efforts to design a chronic sinusitis staging system.
Details
- Title: Subtitle
- Psychiatric distress amplifies symptoms after surgery for chronic rhinosinusitis
- Creators
- Greg E. Davis - VA Puget Sound Health Care SystemBevan Yueh - VA Puget Sound Health Care SystemEdward Walker - University of WashingtonWayne Katon - University of WashingtonThomas D. Koepsell - University of WashingtonErnest A. Weymuller - University of Washington
- Resource Type
- Journal article
- Publication Details
- Otolaryngology-head and neck surgery, Vol.132(2), pp.189-196
- DOI
- 10.1016/j.otohns.2004.09.135
- PMID
- 15692525
- NLM abbreviation
- Otolaryngol Head Neck Surg
- ISSN
- 0194-5998
- eISSN
- 1097-6817
- Publisher
- SAGE Publications
- Number of pages
- 8
- Language
- English
- Date published
- 02/2005
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984966754302771
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