Perioperative anxiety and depression among adults undergoing elective surgery: a cross-sectional survey


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Che Ani, A. A., Dharmalingam, T. K. ., Che Senapi, N. A., Basir, P. S. Z. ., & Abd Halin, M. E. . (2023). Perioperative anxiety and depression among adults undergoing elective surgery: a cross-sectional survey. Malaysian Journal of Anaesthesiology, 2(1), 25–40.

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Copyright (c) 2023 Amira Aishah Che Ani, T. Kumaravadivel Dharmalingam, Noor Azura Che Senapi, Puteri Siti Zaharah Basir, Mohamad Ehsan Abd. Halin


elective surgery; fear; perioperative anxiety; perioperative depression


Introduction: Perioperative anxiety and depression are common disorders worldwide. They are not only associated with significant surgical and anaesthetic morbidity, but also mortality. We aim to determine the prevalence and risk factors associated with perioperative anxiety and depression in a single-study centre.

Methods: This cross-sectional study was conducted from April 1 to August 31 2022, among patients undergoing elective surgery in Hospital Tuanku Fauziah, Perlis. Patients scheduled for perioperative assessment in the Anaesthesiology clinic were invited to participate. The validated Hospital Anxiety and Depression Scale (M-HADS) was used to assess anxiety and depression symptoms before the scheduled surgery. Multiple logistic regression was performed to determine the associated factors to perioperative anxiety and depression.

Results: A total of 340 participants were included in analysis: 15.6% scored significant perioperative depression and 17.4% scored significant perioperative anxiety. High levels of self-rated fear were significantly associated with both anxiety (adjusted OR: 27.46, 95% CI: 5.37, 140.38) and depression (adjusted OR: 2.81, 95% CI: 1.08, 7.27). Otherwise, there were no demographic risk factors associated with perioperative anxiety, while male gender was found to be predictive of perioperative depression (adjusted OR: 2.08, 95% CI: 0.36, 12.15).

Conclusions: We found that 1 in every 6 patients undergoing surgery suffers from perioperative anxiety or depression. Self-rated fear was the independent risk factor for perioperative anxiety, while gender and self-rated fear were independent risk factors for perioperative depression. Effective screening strategies to detect patients at risk of perioperative anxiety or depression are essential for appropriate risk stratification and intervention.


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