Depression often improves after surgery

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Otolaryngol Head Neck Surg. 2011 Mar;144(3):446-451. Epub 2011 Feb 1.Role of Depression in Outcomes of Endoscopic Sinus Surgery.Litvack JR, Mace J, TL.Department of Otology and Laryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.AbstractObjective. To prospectively measure the prevalence and effect of symptomatic depression on chronic rhinosinusitis (CRS) patients' quality of life (QOL), disease severity, and outcomes of endoscopic sinus surgery (ESS). Study Design. Prospective cohort study. Setting. Academic, tertiary care center. Subjects and Methods. Seventy-six patients with CRS were enrolled prior to ESS and followed postoperatively for a mean (SD) of 13.3 (5.4) months. Lund-Mackay computed tomography score, Lund-Kennedy endoscopy score, Patient Health Questionnaire-9 (PHQ-9), 2 disease-specific QOL instruments (Rhinosinusitis Disability Index [RSDI] and Chronic Sinusitis Survey [CSS]), and 1 general QOL instrument (Medical Outcomes Study Short Form-36 [sF-36]) were measured. Differences in outcome scores were analyzed using univariate and multivariate analyses. Results. Only 7 (9.2%) patients reported a history of depression, but 19 (25.0%) patients scored in the range of moderate or severe depression on the PHQ-9. Mean (SD) preoperative scores were significantly worse in depressed patients on the RSDI (62.7 [18.2] vs 45.3 [16.3]; P < .001) and 7 of 8 SF-36 domains (all P ≤ .011). Patients with depression significantly improved on both disease-specific QOL instruments (mean [sD] change; RSDI: 33.5 [24.7], P = .017; CSS: 25.0 [20.9], P = .012) and 3 SF-36 domains (all P ≤ .050). Postoperative change scores were not significantly different from patients without depression on the RSDI, CSS, or SF-36. Severity of depression significantly improved postoperatively in depressed patients (preoperative PHQ-9 scores: 13.4 [2.0] vs 6.1 [4.5], P = .017). Conclusion. CRS patients with depression had worse baseline QOL than other CRS patients but experienced comparable postoperative improvement in QOL after ESS. Interestingly, depression severity significantly improved after ESS.