Jamie R Litvack1, Jess Mace, Timothy L Smith. 1. Department of Otology and Laryngology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
OBJECTIVE: 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.
OBJECTIVE: 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 depressedpatients 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 depressedpatients (preoperative PHQ-9 scores: 13.4 [2.0] vs 6.1 [4.5], P = .017). CONCLUSION:CRSpatients with depression had worse baseline QOL than other CRSpatients but experienced comparable postoperative improvement in QOL after ESS. Interestingly, depression severity significantly improved after ESS.
Authors: Paul E Greenberg; Ronald C Kessler; Howard G Birnbaum; Stephanie A Leong; Sarah W Lowe; Patricia A Berglund; Patricia K Corey-Lisle Journal: J Clin Psychiatry Date: 2003-12 Impact factor: 4.384
Authors: Margaret May; Peter McCarron; Stephen Stansfeld; Yoav Ben-Shlomo; John Gallacher; John Yarnell; George Davey Smith; Peter Elwood; Shah Ebrahim Journal: Stroke Date: 2002-01 Impact factor: 7.914
Authors: Timothy L Smith; Jamie R Litvack; Peter H Hwang; Todd A Loehrl; Jess C Mace; Karen J Fong; Kenneth E James Journal: Otolaryngol Head Neck Surg Date: 2010-01 Impact factor: 3.497
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Doreen Koretz; Kathleen R Merikangas; A John Rush; Ellen E Walters; Philip S Wang Journal: JAMA Date: 2003-06-18 Impact factor: 56.272
Authors: Timothy L Smith; Rodney J Schlosser; Jess C Mace; Jeremiah A Alt; Daniel M Beswick; Adam S DeConde; Kara Y Detwiller; Jose L Mattos; Zachary M Soler Journal: Int Forum Allergy Rhinol Date: 2019-06-17 Impact factor: 3.858
Authors: Joshua L Kennedy; Matthew A Hubbard; Phillip Huyett; James T Patrie; Larry Borish; Spencer C Payne Journal: Ann Allergy Asthma Immunol Date: 2013-07-30 Impact factor: 6.347
Authors: Joshua M Levy; Jess C Mace; Adam S DeConde; Toby O Steele; Timothy L Smith Journal: Int Forum Allergy Rhinol Date: 2016-04-15 Impact factor: 3.858
Authors: Rodney J Schlosser; Kristina Storck; Bernadette M Cortese; Thomas W Uhde; Luke Rudmik; Zachary M Soler Journal: Am J Rhinol Allergy Date: 2016 Mar-Apr Impact factor: 2.467
Authors: Anni Koskinen; Matti Penttilä; Jyri Myller; Sari Hammarén-Malmi; Juha Silvola; Tari Haahtela; Maija Hytönen; Sanna Toppila-Salmi Journal: Am J Rhinol Allergy Date: 2012 Nov-Dec Impact factor: 2.467
Authors: Daniel R Cox; Shaelene Ashby; Adam S DeConde; Jess C Mace; Richard R Orlandi; Timothy L Smith; Jeremiah A Alt Journal: Int Forum Allergy Rhinol Date: 2015-11-19 Impact factor: 3.858