TY - JOUR
T1 - Does preoperative depression and/or serotonin transporter gene polymorphism predict outcome after laparoscopic cholecystectomy?
AU - York Surgical Outcomes Research Team
AU - Wright, Barry
AU - Alexander, David
AU - Aghahoseini, Assad
AU - Allgar, Victoria
AU - Wilson, Tim
AU - Bennett, Sophie
AU - Aziz, Naveed
AU - Collingridge-Moore, Danielle
AU - Munafò, Marcus R.
AU - Locker, David
AU - Holbrook, Ian
AU - Anakwe, Kevin
AU - Hooke, Naomi
AU - Alderson-Day, Ben
AU - Davidson, Conor
AU - Tomlinson, Heather
AU - Whalley, Celina
N1 - Publisher Copyright:
© 2016 BMJ Publishing Group. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Objective: To determine whether preoperative psychological depression and/or serotonin transporter gene polymorphism are associated with poor outcomes after the common procedure of laparoscopic cholecystectomy. Design: Patients undergoing laparoscopic cholecystectomy were genotyped for the serotonin transporter gene 5-HTTLPR polymorphism and assessed for psychological morbidity before and 6 weeks after surgery. The main outcome was postoperative depression; secondary outcomes included fatigue, perceived pain, quality of life and subjective perception about return to usual. Results: Full genetic and psychological data were obtained from 273 out of 330 patients consented to the study (82% female). Significantly fewer people with preoperative depression (Beck Depression Inventory (BDI) score >5) had returned to employment (57% vs 86%, p<0.001) or made a full recovery (11% vs 44%, p<0.001) 6 weeks after surgery. Independent predictors for subjective return to usual after surgery included preoperative depression, body mass index and postoperative pain scores. Independent predictors of postoperative depression included preoperative antidepressant use and preoperative depression. SS genotype was associated with use of antidepressants preoperatively and higher anxiety levels after surgery. However, it was not associated with other salient postoperative psychosocial outcomes. Conclusions: Depressive psychological morbidity preoperatively, pain and body mass index appear to be important factors in predicting recovery after this common surgical procedure. There may be a place to include preoperative brief psychological screening to enable targeted support. Our results suggest that the serotonin transporter gene is unlikely to be a useful clinical predictor of outcome in this group. Trial registration number: ISRCTN40219584.
AB - Objective: To determine whether preoperative psychological depression and/or serotonin transporter gene polymorphism are associated with poor outcomes after the common procedure of laparoscopic cholecystectomy. Design: Patients undergoing laparoscopic cholecystectomy were genotyped for the serotonin transporter gene 5-HTTLPR polymorphism and assessed for psychological morbidity before and 6 weeks after surgery. The main outcome was postoperative depression; secondary outcomes included fatigue, perceived pain, quality of life and subjective perception about return to usual. Results: Full genetic and psychological data were obtained from 273 out of 330 patients consented to the study (82% female). Significantly fewer people with preoperative depression (Beck Depression Inventory (BDI) score >5) had returned to employment (57% vs 86%, p<0.001) or made a full recovery (11% vs 44%, p<0.001) 6 weeks after surgery. Independent predictors for subjective return to usual after surgery included preoperative depression, body mass index and postoperative pain scores. Independent predictors of postoperative depression included preoperative antidepressant use and preoperative depression. SS genotype was associated with use of antidepressants preoperatively and higher anxiety levels after surgery. However, it was not associated with other salient postoperative psychosocial outcomes. Conclusions: Depressive psychological morbidity preoperatively, pain and body mass index appear to be important factors in predicting recovery after this common surgical procedure. There may be a place to include preoperative brief psychological screening to enable targeted support. Our results suggest that the serotonin transporter gene is unlikely to be a useful clinical predictor of outcome in this group. Trial registration number: ISRCTN40219584.
UR - http://www.scopus.com/inward/record.url?scp=85012978413&partnerID=8YFLogxK
U2 - 10.1136/BMJOPEN-2015-007969
DO - 10.1136/BMJOPEN-2015-007969
M3 - Article
C2 - 27601483
AN - SCOPUS:85012978413
SN - 2044-6055
VL - 6
JO - BMJ Open
JF - BMJ Open
IS - 9
M1 - e007969
ER -