Depression and anxiety don’t mix well with surgery

Studies have shown that nearly one-third of patients develop psychiatric problems after having a major surgery. But what about patients who have poor mental health before they go under the knife? Does it affect their chances for a full recovery?

It depends on the type of psychiatric condition the patient has, according to a study published this week in Archives of Surgery.

Researchers from the Iowa City Veterans Affairs Medical Center analyzed the medical records of 35,539 VA patients around the country who were admitted to the intensive care unit after a surgical procedure. One-quarter of the vets had some kind of psychiatric condition. Altogether, 16% were depressed, 8% had post-traumatic stress disorder, 7% suffered from anxiety, 2% had bipolar disorder and 2% had psychosis. (Some patients had more than one disorder.)

The patients – 97% of them men – had an average age of 65, though the patients with a psychiatric problem were four years younger, on average. But despite their relative youth, they were 15% more likely to die in the hospital and 21% more likely to die within 30 days of their surgery, the researchers found.

Those deaths primarily occurred among patients with depression (they were 23% more likely to die within 30 days) and anxiety (a 25% increased risk of 30-day mortality). None of the other disorders seemed to affect patients’ recuperation, according to the study.

Why would depression and anxiety make a patient more vulnerable? The researchers offered several theories. Among them:

• Depressed patients don’t take as good a care of themselves, so when they go in for surgery, they may have underlying conditions that complicate their recovery.
• Patients with mental health problems may settle for lower-quality hospitals and surgeons.
• Patients with depression or anxiety may put off going to the doctor, so by the time they have their surgery, their physical condition is worse.

-- Karen Kaplan/Los Angeles Times