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Depression after stoma surgery: a systematic review and meta-analysis
BACKGROUND: Depression is the leading cause of global disability and can develop following the change in body image and functional capacity associated with stoma surgery. However, reported prevalence across the literature is unknown. Accordingly, we performed a systematic review and meta-analysis ai...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10201486/ https://www.ncbi.nlm.nih.gov/pubmed/37217917 http://dx.doi.org/10.1186/s12888-023-04871-0 |
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author | Kovoor, Joshua G. Jacobsen, Jonathan Henry W. Stretton, Brandon Bacchi, Stephen Gupta, Aashray K. Claridge, Brayden Steen, Matthew V. Bhanushali, Ameya Bartholomeusz, Lorenz Edwards, Suzanne Asokan, Gayatri P. Asokan, Gopika McGee, Amanda Ovenden, Christopher D. Hewitt, Joseph N. Trochsler, Markus I. Padbury, Robert T. Perry, Seth W. Wong, Ma-Li Licinio, Julio Maddern, Guy J. Hewett, Peter J. |
author_facet | Kovoor, Joshua G. Jacobsen, Jonathan Henry W. Stretton, Brandon Bacchi, Stephen Gupta, Aashray K. Claridge, Brayden Steen, Matthew V. Bhanushali, Ameya Bartholomeusz, Lorenz Edwards, Suzanne Asokan, Gayatri P. Asokan, Gopika McGee, Amanda Ovenden, Christopher D. Hewitt, Joseph N. Trochsler, Markus I. Padbury, Robert T. Perry, Seth W. Wong, Ma-Li Licinio, Julio Maddern, Guy J. Hewett, Peter J. |
author_sort | Kovoor, Joshua G. |
collection | PubMed |
description | BACKGROUND: Depression is the leading cause of global disability and can develop following the change in body image and functional capacity associated with stoma surgery. However, reported prevalence across the literature is unknown. Accordingly, we performed a systematic review and meta-analysis aiming to characterise depressive symptoms after stoma surgery and potential predictive factors. METHODS: PubMed/MEDLINE, Embase, CINAHL and Cochrane Library were searched from respective database inception to 6 March 2023 for studies reporting rates of depressive symptoms after stoma surgery. Risk of bias was assessed using the Downs and Black checklist for non-randomised studies of interventions (NRSIs), and Cochrane RoB2 tool for randomised controlled trials (RCTs). Meta-analysis incorporated meta-regressions and a random-effects model. Registration: PROSPERO, CRD42021262345. RESULTS: From 5,742 records, 68 studies were included. According to Downs and Black checklist, the 65 NRSIs were of low to moderate methodological quality. According to Cochrane RoB2, the three RCTs ranged from low risk of bias to some concerns of bias. Thirty-eight studies reported rates of depressive symptoms after stoma surgery as a proportion of the respective study populations, and from these, the median rate across all timepoints was 42.9% 42.9% (IQR: 24.2–58.9%). Pooled scores for respective validated depression measures (Hospital Anxiety and Depression Score (HADS), Beck Depression Inventory (BDI), and Patient Health Questionnaire-9 (PHQ-9)) across studies reporting those scores were below clinical thresholds for major depressive disorder according to severity criteria of the respective scores. In the three studies that used the HADS to compare non-stoma versus stoma surgical populations, depressive symptoms were 58% less frequent in non-stoma populations. Region (Asia–Pacific; Europe; Middle East/Africa; North America) was significantly associated with postoperative depressive symptoms (p = 0.002), whereas age (p = 0.592) and sex (p = 0.069) were not. CONCLUSIONS: Depressive symptoms occur in almost half of stoma surgery patients, which is higher than the general population, and many inflammatory bowel disease and colorectal cancer populations outlined in the literature. However, validated measures suggest this is mostly at a level of clinical severity below major depressive disorder. Stoma patient outcomes and postoperative psychosocial adjustment may be enhanced by increased psychological evaluation and care in the perioperative period. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-023-04871-0. |
format | Online Article Text |
id | pubmed-10201486 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102014862023-05-23 Depression after stoma surgery: a systematic review and meta-analysis Kovoor, Joshua G. Jacobsen, Jonathan Henry W. Stretton, Brandon Bacchi, Stephen Gupta, Aashray K. Claridge, Brayden Steen, Matthew V. Bhanushali, Ameya Bartholomeusz, Lorenz Edwards, Suzanne Asokan, Gayatri P. Asokan, Gopika McGee, Amanda Ovenden, Christopher D. Hewitt, Joseph N. Trochsler, Markus I. Padbury, Robert T. Perry, Seth W. Wong, Ma-Li Licinio, Julio Maddern, Guy J. Hewett, Peter J. BMC Psychiatry Research BACKGROUND: Depression is the leading cause of global disability and can develop following the change in body image and functional capacity associated with stoma surgery. However, reported prevalence across the literature is unknown. Accordingly, we performed a systematic review and meta-analysis aiming to characterise depressive symptoms after stoma surgery and potential predictive factors. METHODS: PubMed/MEDLINE, Embase, CINAHL and Cochrane Library were searched from respective database inception to 6 March 2023 for studies reporting rates of depressive symptoms after stoma surgery. Risk of bias was assessed using the Downs and Black checklist for non-randomised studies of interventions (NRSIs), and Cochrane RoB2 tool for randomised controlled trials (RCTs). Meta-analysis incorporated meta-regressions and a random-effects model. Registration: PROSPERO, CRD42021262345. RESULTS: From 5,742 records, 68 studies were included. According to Downs and Black checklist, the 65 NRSIs were of low to moderate methodological quality. According to Cochrane RoB2, the three RCTs ranged from low risk of bias to some concerns of bias. Thirty-eight studies reported rates of depressive symptoms after stoma surgery as a proportion of the respective study populations, and from these, the median rate across all timepoints was 42.9% 42.9% (IQR: 24.2–58.9%). Pooled scores for respective validated depression measures (Hospital Anxiety and Depression Score (HADS), Beck Depression Inventory (BDI), and Patient Health Questionnaire-9 (PHQ-9)) across studies reporting those scores were below clinical thresholds for major depressive disorder according to severity criteria of the respective scores. In the three studies that used the HADS to compare non-stoma versus stoma surgical populations, depressive symptoms were 58% less frequent in non-stoma populations. Region (Asia–Pacific; Europe; Middle East/Africa; North America) was significantly associated with postoperative depressive symptoms (p = 0.002), whereas age (p = 0.592) and sex (p = 0.069) were not. CONCLUSIONS: Depressive symptoms occur in almost half of stoma surgery patients, which is higher than the general population, and many inflammatory bowel disease and colorectal cancer populations outlined in the literature. However, validated measures suggest this is mostly at a level of clinical severity below major depressive disorder. Stoma patient outcomes and postoperative psychosocial adjustment may be enhanced by increased psychological evaluation and care in the perioperative period. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-023-04871-0. BioMed Central 2023-05-22 /pmc/articles/PMC10201486/ /pubmed/37217917 http://dx.doi.org/10.1186/s12888-023-04871-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Kovoor, Joshua G. Jacobsen, Jonathan Henry W. Stretton, Brandon Bacchi, Stephen Gupta, Aashray K. Claridge, Brayden Steen, Matthew V. Bhanushali, Ameya Bartholomeusz, Lorenz Edwards, Suzanne Asokan, Gayatri P. Asokan, Gopika McGee, Amanda Ovenden, Christopher D. Hewitt, Joseph N. Trochsler, Markus I. Padbury, Robert T. Perry, Seth W. Wong, Ma-Li Licinio, Julio Maddern, Guy J. Hewett, Peter J. Depression after stoma surgery: a systematic review and meta-analysis |
title | Depression after stoma surgery: a systematic review and meta-analysis |
title_full | Depression after stoma surgery: a systematic review and meta-analysis |
title_fullStr | Depression after stoma surgery: a systematic review and meta-analysis |
title_full_unstemmed | Depression after stoma surgery: a systematic review and meta-analysis |
title_short | Depression after stoma surgery: a systematic review and meta-analysis |
title_sort | depression after stoma surgery: a systematic review and meta-analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10201486/ https://www.ncbi.nlm.nih.gov/pubmed/37217917 http://dx.doi.org/10.1186/s12888-023-04871-0 |
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