| Objectives: To investigate the impact of psychiatric comorbidity on chronicrhinosinusitis and to determine how psychiatric disorder influences outcomes withsurgical treatment for chronic rhinosinusitis.Methods: This is an observational study of patients diagnosed with CRS presenting forsurgery. Patients were interviewed before surgery; CT scans and endoscopy werereviewed, and questionnaires were completed about Visual Analogue Scale (VAS), Self-reporting Inventory90(SCL-90), Self-Rating Anxiety Scale (SAS) and Self-RatingDepression Scale (SDS).Outcomes were also assessed3month postoperatively.Result:There were80patients and46the families of patients enrolled.1. Mild levels of psychiatric disorders were noted in68%, with high score forSomatization(1.67±0.42), Interpersonal Sensitivity(1.80±0.46), Hostility(1.75±0.65),Other(1.88±0.52) and General Symptomatic Index(1.65±0.35) compared withcontrol group that were reported by1.36±0.49,1.43±0.50,1.38±0.47,1.39±0.46and1.46±0.44(P<0.05).2. A positive correlation was noted between Interpersonal Sensitivity and symptomsscores(r=0.349,P=0.022) and CT scores (r=0.320,P=0.005).A positive correlationwas noted between hostility and symptoms scores(r=0.0.312,P=0.007) and CTscores (r=0.268,P=0.022).A positive correlation was noted between GSI andsymptoms scores(r=0.382,P=0.001) and CT scores (r=0.285,P=0.015).A positivecorrelation was noted between Other scores and CT scores (P<0.05).3. The scores of GSI(z=-2.31,P=0.021） and Interpersonal Sensitivity(z=-3.04,P=0.002) in female was lower than male’(P<0.05). Adjusting for educational background, therewas no difficult between anxiety scores and depression scores.4. In CRS’s group, mild levels of anxiety and depression were noted in17.87%and30.43%, respectively. Patients reported significant elevations (t=2.05, P=0.04) ofdepression scores(0.46±0.10) in comparison with the control group(0.40±0.12)(P<0.05).5. We did not find association between anxiety and symptoms scores and CT scores andendoscopic scores. We also did not find association between depression andsymptoms scores and CT scores and endoscopic scores.6. The scores of Axiety scores in female was lower than male’s(t=2.05,P=0.016）.Adjusting for sex and educational background (P<0.05).7. There was no difficult between anxiety scores and depression scores.There were38patients with surgery enrolled. Subjects are divided into groups by anxietyand depression, with the result statistics and compared.8. After surgery, depression scores (t=6.517, P=0.000) and anxiety scores (t=6.832,P=0.000) of patients decreased except GSI scores(P<0.05).9. After surgery, snot scores of the patients in anxiety group were lower than patientsin non-anxiety group(t=-2.281,P=0.029）(P<0.05).10. In anxiety group, the preoperative scores of stuffy nose(t=5.103,P=0.001）,snot(t=3.738,P=0.005）, headache(t=2.795,P=0.021）, hyposmia(z=-3.113,P=0.000）,VAS(t=4.868,P=0.001） and L-K(t=2.332,P=0.045） were lower than postoperativescores(P<0.05).11. In non-anxiety group, the preoperative scores of stuffy nose(t=10.625,P=0.000）,snot(t=2.633,P=0.016）, headache(t=3.679,P=0.001）, hyposmia(t=2.113,P=0.012）,fatigue(t=7.603,P=0.000）, VAS(t=5.127,P=0.000）,L-K(z=2.805,P=0.005） andGSI(t=2.104,P=0.048） were lower than postoperative scores(P<0.05).12. After surgery, stuffy nose score(t=-2.81,P=0.009）,snot score(t=-2.89,P=0.006）,headache score(z=-4.084,P=0.000）, hyposmia score(t=-2.16,P=0.000）,VAS score(t=-4.223,P=0.036）and L-K score(t=2.633,P=0.000） of the patients in depression group were lower than patients in non-depressiongroup(P<0.05).13. In depression group, the postoperative scores of stuffy nose(t=8.308,P=0.000）,snot(t=3.211,P=0.008）, headache(t=2.590,P=0.025）, fatigue(t=2.227,P=0.048）,VAS(t=4.917,P=0.000） and L-K(z=-3.276,P=0.001） were lower than preoperativescores(P<0.05).14. In non-depression group, the postoperative scores of stuffy nose(t=8.620,P=0.000）,snot(t=2.660,P=0.017）, headache(t=4.410,P=0.00）, hyposmia(t=4.751,P=0.000）,fatigue(t=3.938,P=0.001）, VAS(t=7.107,P=0.000）,L-K(z=3.211,P=0.009） andGSI(t=3.211,P=0.048） were lower than preoperative scores(P<0.05).Conclusions:1、Psychiatric disorders, especially anxiety and depression, are prevalent in patients withCRS.2、Some of psychiatric comorbidity do correlate with CRS symptoms and imaging testsexcept anxiety and depression.3、Anxiety and depression are associated with increased symptoms in CRS before andafter surgery compared with non-anxiety and non-depression, separately.4、Depression may be one of the important factors affecting prognosis.5、Surgical dffect is partly related to the patient`spsychological state. |
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