Improvements in psychological dysfunction after endoscopic sinus surgery for patients with chronic rhinosinusitis

Joshua M. Levy, Jess C. Mace, Adam S. DeConde, Toby Steele, Timothy Smith

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Psychological dysfunction is highly prevalent among patients with chronic rhinosinusitis (CRS). Previous study has identified various measures of anxiety and depression as predictors of quality-of-life outcomes following endoscopic sinus surgery (ESS). Psychological dysfunction scores, as measured by the 22-item Sino-Nasal Outcome Test (SNOT-22), have been found to influence treatment decision making in CRS. This study aims to further elucidate improvement in discrete psychological symptoms following ESS for CRS. Methods: Adult patients with medically recalcitrant CRS electing to undergo ESS were prospectively enrolled into a multi-institutional, observational cohort. Psychological-related symptom severity and postoperative outcomes were assessed using psychological domain items of the SNOT-22, including subgroup analysis of patients with and without comorbid depression. Results: A total of 374 participants met inclusion criteria and were followed postoperatively for a mean ± standard deviation (SD) of 14.6 ± 5.0 months. Total mean psychological domain scores improved from 15.9 ± 8.2 to 8.5 ± 8.4 (p < 0.001). Significant relative mean improvements were reported in “waking up tired” (23%; p < 0.001), “fatigue” (25%; p < 0.001), “reduced productivity” (28%; p < 0.001), “reduced concentration” (27%; p < 0.001), “ frustrated/restless/irritable” (27%; p < 0.001), “sad” (15%; p < 0.001), and “embarrassed” (8%; p < 0.001) scores. A total of 64% to 66% of participants reported improvement in “reduced productivity,” “waking up tired,” “fatigue,” and “frustrated/restless/irritable,” compared to 46% and 38% reporting improvement in “sad” and “embarrassed,” respectively. Conclusion: Patients with CRS report significant improvement in common mental health–related symptoms following ESS. Despite these improvements, some degree of persistent postoperative psychological dysfunction was reported. Further study is necessary to determine which factors are associated with persistent psychological dysfunction after ESS in order to optimize treatment outcomes.

Original languageEnglish (US)
Pages (from-to)906-913
Number of pages8
JournalInternational Forum of Allergy and Rhinology
Volume6
Issue number9
DOIs
StatePublished - Sep 1 2016

Fingerprint

Psychology
Fatigue
Depression
Nose
Decision Making
Anxiety
Quality of Life

Keywords

  • chronic rhinosinusitis
  • endoscopic sinus surgery
  • patient outcome assessment
  • psychology
  • quality of life
  • sinusitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Improvements in psychological dysfunction after endoscopic sinus surgery for patients with chronic rhinosinusitis. / Levy, Joshua M.; Mace, Jess C.; DeConde, Adam S.; Steele, Toby; Smith, Timothy.

In: International Forum of Allergy and Rhinology, Vol. 6, No. 9, 01.09.2016, p. 906-913.

Research output: Contribution to journalArticle

@article{3c97aaf830d74ace953c63daf932f14c,
title = "Improvements in psychological dysfunction after endoscopic sinus surgery for patients with chronic rhinosinusitis",
abstract = "Background: Psychological dysfunction is highly prevalent among patients with chronic rhinosinusitis (CRS). Previous study has identified various measures of anxiety and depression as predictors of quality-of-life outcomes following endoscopic sinus surgery (ESS). Psychological dysfunction scores, as measured by the 22-item Sino-Nasal Outcome Test (SNOT-22), have been found to influence treatment decision making in CRS. This study aims to further elucidate improvement in discrete psychological symptoms following ESS for CRS. Methods: Adult patients with medically recalcitrant CRS electing to undergo ESS were prospectively enrolled into a multi-institutional, observational cohort. Psychological-related symptom severity and postoperative outcomes were assessed using psychological domain items of the SNOT-22, including subgroup analysis of patients with and without comorbid depression. Results: A total of 374 participants met inclusion criteria and were followed postoperatively for a mean ± standard deviation (SD) of 14.6 ± 5.0 months. Total mean psychological domain scores improved from 15.9 ± 8.2 to 8.5 ± 8.4 (p < 0.001). Significant relative mean improvements were reported in “waking up tired” (23{\%}; p < 0.001), “fatigue” (25{\%}; p < 0.001), “reduced productivity” (28{\%}; p < 0.001), “reduced concentration” (27{\%}; p < 0.001), “ frustrated/restless/irritable” (27{\%}; p < 0.001), “sad” (15{\%}; p < 0.001), and “embarrassed” (8{\%}; p < 0.001) scores. A total of 64{\%} to 66{\%} of participants reported improvement in “reduced productivity,” “waking up tired,” “fatigue,” and “frustrated/restless/irritable,” compared to 46{\%} and 38{\%} reporting improvement in “sad” and “embarrassed,” respectively. Conclusion: Patients with CRS report significant improvement in common mental health–related symptoms following ESS. Despite these improvements, some degree of persistent postoperative psychological dysfunction was reported. Further study is necessary to determine which factors are associated with persistent psychological dysfunction after ESS in order to optimize treatment outcomes.",
keywords = "chronic rhinosinusitis, endoscopic sinus surgery, patient outcome assessment, psychology, quality of life, sinusitis",
author = "Levy, {Joshua M.} and Mace, {Jess C.} and DeConde, {Adam S.} and Toby Steele and Timothy Smith",
year = "2016",
month = "9",
day = "1",
doi = "10.1002/alr.21776",
language = "English (US)",
volume = "6",
pages = "906--913",
journal = "International Forum of Allergy and Rhinology",
issn = "2042-6976",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Improvements in psychological dysfunction after endoscopic sinus surgery for patients with chronic rhinosinusitis

AU - Levy, Joshua M.

AU - Mace, Jess C.

AU - DeConde, Adam S.

AU - Steele, Toby

AU - Smith, Timothy

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background: Psychological dysfunction is highly prevalent among patients with chronic rhinosinusitis (CRS). Previous study has identified various measures of anxiety and depression as predictors of quality-of-life outcomes following endoscopic sinus surgery (ESS). Psychological dysfunction scores, as measured by the 22-item Sino-Nasal Outcome Test (SNOT-22), have been found to influence treatment decision making in CRS. This study aims to further elucidate improvement in discrete psychological symptoms following ESS for CRS. Methods: Adult patients with medically recalcitrant CRS electing to undergo ESS were prospectively enrolled into a multi-institutional, observational cohort. Psychological-related symptom severity and postoperative outcomes were assessed using psychological domain items of the SNOT-22, including subgroup analysis of patients with and without comorbid depression. Results: A total of 374 participants met inclusion criteria and were followed postoperatively for a mean ± standard deviation (SD) of 14.6 ± 5.0 months. Total mean psychological domain scores improved from 15.9 ± 8.2 to 8.5 ± 8.4 (p < 0.001). Significant relative mean improvements were reported in “waking up tired” (23%; p < 0.001), “fatigue” (25%; p < 0.001), “reduced productivity” (28%; p < 0.001), “reduced concentration” (27%; p < 0.001), “ frustrated/restless/irritable” (27%; p < 0.001), “sad” (15%; p < 0.001), and “embarrassed” (8%; p < 0.001) scores. A total of 64% to 66% of participants reported improvement in “reduced productivity,” “waking up tired,” “fatigue,” and “frustrated/restless/irritable,” compared to 46% and 38% reporting improvement in “sad” and “embarrassed,” respectively. Conclusion: Patients with CRS report significant improvement in common mental health–related symptoms following ESS. Despite these improvements, some degree of persistent postoperative psychological dysfunction was reported. Further study is necessary to determine which factors are associated with persistent psychological dysfunction after ESS in order to optimize treatment outcomes.

AB - Background: Psychological dysfunction is highly prevalent among patients with chronic rhinosinusitis (CRS). Previous study has identified various measures of anxiety and depression as predictors of quality-of-life outcomes following endoscopic sinus surgery (ESS). Psychological dysfunction scores, as measured by the 22-item Sino-Nasal Outcome Test (SNOT-22), have been found to influence treatment decision making in CRS. This study aims to further elucidate improvement in discrete psychological symptoms following ESS for CRS. Methods: Adult patients with medically recalcitrant CRS electing to undergo ESS were prospectively enrolled into a multi-institutional, observational cohort. Psychological-related symptom severity and postoperative outcomes were assessed using psychological domain items of the SNOT-22, including subgroup analysis of patients with and without comorbid depression. Results: A total of 374 participants met inclusion criteria and were followed postoperatively for a mean ± standard deviation (SD) of 14.6 ± 5.0 months. Total mean psychological domain scores improved from 15.9 ± 8.2 to 8.5 ± 8.4 (p < 0.001). Significant relative mean improvements were reported in “waking up tired” (23%; p < 0.001), “fatigue” (25%; p < 0.001), “reduced productivity” (28%; p < 0.001), “reduced concentration” (27%; p < 0.001), “ frustrated/restless/irritable” (27%; p < 0.001), “sad” (15%; p < 0.001), and “embarrassed” (8%; p < 0.001) scores. A total of 64% to 66% of participants reported improvement in “reduced productivity,” “waking up tired,” “fatigue,” and “frustrated/restless/irritable,” compared to 46% and 38% reporting improvement in “sad” and “embarrassed,” respectively. Conclusion: Patients with CRS report significant improvement in common mental health–related symptoms following ESS. Despite these improvements, some degree of persistent postoperative psychological dysfunction was reported. Further study is necessary to determine which factors are associated with persistent psychological dysfunction after ESS in order to optimize treatment outcomes.

KW - chronic rhinosinusitis

KW - endoscopic sinus surgery

KW - patient outcome assessment

KW - psychology

KW - quality of life

KW - sinusitis

UR - http://www.scopus.com/inward/record.url?scp=84985916497&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84985916497&partnerID=8YFLogxK

U2 - 10.1002/alr.21776

DO - 10.1002/alr.21776

M3 - Article

VL - 6

SP - 906

EP - 913

JO - International Forum of Allergy and Rhinology

JF - International Forum of Allergy and Rhinology

SN - 2042-6976

IS - 9

ER -