The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery
Abstract Background Depression and chronic pain are debilitating disorders that co-exist with many chronic diseases. Chronic rhinosinusitis (CRS) is no exception. Nonetheless, little is known about the association between these co-related conditions and the treatment of CRS. The objective of this st...
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SAGE Publishing
2019-04-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s40463-019-0340-0 |
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| author | Javier Ospina Guiping Liu Trafford Crump Jason M. Sutherland Arif Janjua |
| author_facet | Javier Ospina Guiping Liu Trafford Crump Jason M. Sutherland Arif Janjua |
| author_sort | Javier Ospina |
| collection | DOAJ |
| description | Abstract Background Depression and chronic pain are debilitating disorders that co-exist with many chronic diseases. Chronic rhinosinusitis (CRS) is no exception. Nonetheless, little is known about the association between these co-related conditions and the treatment of CRS. The objective of this study is to measure outcomes following endoscopic sinus surgery (ESS) in CRS patients reporting significant pre-operative depression and pain. Methods This is a prospective longitudinal cohort study examining patients with CRS who had failed maximal medical therapy and subsequently underwent ESS. Participants completed a several patient-reported outcome (PRO) instruments pre-operatively and 6 months post-operatively. The PROs included the Sinonasal Outcome Test-22 (SNOT-22), the Patient Health Questionnaire (PHQ-9) measuring symptoms of depression and an assessment of chronic pain using the pain intensity (P), interference with enjoyment of life (E) and general (G) activity instrument, the PEG instrument. Results The study had 142 participants complete their pre-operative and post-operative surveys. The participation rate was 40.1% among eligible patients. The prevalence of at least moderate depression was 22 patients (15.5%) among participants. Compared with non-depressed participants, the pre-operative sino-nasal disease burden and pain scores were higher among depressed participants (p < 0.001) and the gain in health following surgery was smaller (p < 0.001). Conclusions Pre-operative disease burden is higher among depressed patients. Post-operative gains in sino-nasal quality of life attributable to endoscopic sinus surgery were significantly smaller among depressed participants. Pre-operative screening for depression could identify opportunities for medical intervention and improve outcomes among CRS patients. |
| format | Article |
| id | doaj-art-c3fa6d3107964c8385ac188509e2c602 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2019-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-c3fa6d3107964c8385ac188509e2c6022025-02-03T00:22:57ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162019-04-014811710.1186/s40463-019-0340-0The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgeryJavier Ospina0Guiping Liu1Trafford Crump2Jason M. Sutherland3Arif Janjua4Division of Otolaryngology - Head and Neck Surgery, Sinus and Skull Base Surgery, Department of Surgery, University of British Columbia, Vancouver General HospitalCentre for Health Services and Policy Research, School of Population and Public Health, University of British ColumbiaDepartment of Surgery, University of CalgaryCentre for Health Services and Policy Research, School of Population and Public Health, University of British ColumbiaRhinology, Endoscopic Sinus and Skull Base Surgery, Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of British ColumbiaAbstract Background Depression and chronic pain are debilitating disorders that co-exist with many chronic diseases. Chronic rhinosinusitis (CRS) is no exception. Nonetheless, little is known about the association between these co-related conditions and the treatment of CRS. The objective of this study is to measure outcomes following endoscopic sinus surgery (ESS) in CRS patients reporting significant pre-operative depression and pain. Methods This is a prospective longitudinal cohort study examining patients with CRS who had failed maximal medical therapy and subsequently underwent ESS. Participants completed a several patient-reported outcome (PRO) instruments pre-operatively and 6 months post-operatively. The PROs included the Sinonasal Outcome Test-22 (SNOT-22), the Patient Health Questionnaire (PHQ-9) measuring symptoms of depression and an assessment of chronic pain using the pain intensity (P), interference with enjoyment of life (E) and general (G) activity instrument, the PEG instrument. Results The study had 142 participants complete their pre-operative and post-operative surveys. The participation rate was 40.1% among eligible patients. The prevalence of at least moderate depression was 22 patients (15.5%) among participants. Compared with non-depressed participants, the pre-operative sino-nasal disease burden and pain scores were higher among depressed participants (p < 0.001) and the gain in health following surgery was smaller (p < 0.001). Conclusions Pre-operative disease burden is higher among depressed patients. Post-operative gains in sino-nasal quality of life attributable to endoscopic sinus surgery were significantly smaller among depressed participants. Pre-operative screening for depression could identify opportunities for medical intervention and improve outcomes among CRS patients.http://link.springer.com/article/10.1186/s40463-019-0340-0Chronic rhinosinusitisEndoscopic sinus surgeryQuality of lifeSymptom severityPatient-reported outcomes |
| spellingShingle | Javier Ospina Guiping Liu Trafford Crump Jason M. Sutherland Arif Janjua The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery Journal of Otolaryngology - Head and Neck Surgery Chronic rhinosinusitis Endoscopic sinus surgery Quality of life Symptom severity Patient-reported outcomes |
| title | The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery |
| title_full | The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery |
| title_fullStr | The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery |
| title_full_unstemmed | The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery |
| title_short | The impact of comorbid depression in chronic rhinosinusitis on post-operative sino-nasal quality of life and pain following endoscopic sinus surgery |
| title_sort | impact of comorbid depression in chronic rhinosinusitis on post operative sino nasal quality of life and pain following endoscopic sinus surgery |
| topic | Chronic rhinosinusitis Endoscopic sinus surgery Quality of life Symptom severity Patient-reported outcomes |
| url | http://link.springer.com/article/10.1186/s40463-019-0340-0 |
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