Cancer Res Treat.  2022 Oct;54(4):1138-1147. 10.4143/crt.2021.842.

Prevalence of Psychological Symptoms in Patients Undergoing Pancreatoduodenectomy and Results of a Distress Management System: A Clinic-Based Study

• Kang MJ
• Yu ES
• Kang YH
• Park HM
• Park SJ
• Kim SW
• Kim JH
• Han SS

• KMID: 2534193
• DOI: http://doi.org/10.4143/crt.2021.842

Abstract

Purpose
Patients undergoing pancreatoduodenectomy are a high-risk group that requires psychosocial support. This study retrospectively reviewed the prevalence of psychological symptoms in patients undergoing pancreatoduodenectomy for periampullary neoplasm and the psychosocial referral rate after implementing full screening and triage algorithm for administering a distress management protocol based on the integrated supportive care system established in 2010.
Materials and Methods
From September 2010 to December 2018, insomnia, anxiety, and depression were screened on the first day of admission (T1) and on the 10th postoperative day (T2). Patients with clinical levels of distress were referred to a mental health clinic for appropriate aftercare.
Results
The adherence rate to routine screening was 82.7% (364/440). Among the 364 patients, the prevalence of insomnia, anxiety, and depression increased from 22.0% (T1) to 32.6% (T2, p=0.001), 29.1% to 33.6% (p=0.256), and 18.4% to 27.6% (p=0.001), respectively. Less than 45% of those with psychological symptoms expressed their needs for psychological supportive care. Among those with psychological symptoms at T2, clinical insomnia, anxiety, and depression were detected via in-depth evaluations among 77.2%, 38.1%, and 82.5% of patients, respectively. Patients who had two or more symptoms at T2 had a longer postoperative hospital stay, as compared to those with one or no symptoms (a median of 20.5 days vs. 18.0 days, p=0.006). Psychiatric consultation rate was 72.8% among patients with clinical psychological symptoms, and 74% of the consulted patients completed psychiatric intervention before discharge.
Conclusion
Over one-third of the patients had psychological symptoms before and after pancreatoduodenectomy. Implementing a routine psychological symptoms screening with a systematic psychiatric referral protocol enhanced surgeons’ responsiveness to patients’ psychological symptoms.

Keyword

Neoplasms; Oncology; Periampullary cancer; Pancreatoduodenectomy; Psychological symptoms

Figure

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  Fig. 1 Screening results on the first day of admission (T1) and the tenth postoperative day (T2) using National Cancer Center Psychological Symptom Inventory.

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  Fig. 2 Serial prevalence and severity of psychological symptoms at T1 and T2, and with in-depth questionnaires for symptomatic patients at T2: insomnia (A), anxiety (B), and depression (C). ISI, Insomnia Severity Index; STAI-X, Korean version of the self-reported State-Trait Anxiety Inventory.

Reference

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