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Depression after stoma surgery: a systematic review and meta-analysis
Joshua G Kovoor1,2,3,4,5,6, Jonathan Henry W Jacobsen7, Brandon Stretton8,9,10,11
1University of Adelaide, Adelaide, South Australia, Australia. joshua.kovoor@adelaide.edu.au.
BMC Psychiatry
|May 22, 2023
Summary
Depressive symptoms affect nearly half of stoma surgery patients. While prevalent, symptoms are typically below major depressive disorder thresholds, suggesting a need for enhanced psychological support post-surgery.
Area of Science:
- Medical and Health Sciences
- Psychiatry and Psychology
- Surgical Oncology
Background:
- Depression is a leading global disability, often linked to body image changes after stoma surgery.
- The prevalence of depressive symptoms post-stoma surgery requires systematic investigation.
- This study aims to characterize depressive symptoms and identify predictive factors in stoma patients.
Approach:
- A systematic review and meta-analysis of studies reporting depressive symptoms after stoma surgery.
- Searched PubMed/MEDLINE, Embase, CINAHL, and Cochrane Library up to March 2023.
- Assessed risk of bias using Downs and Black checklist and Cochrane RoB2 tool, employing meta-regressions and a random-effects model.
Key Points:
- Included 68 studies with a median depressive symptom rate of 42.9% across all timepoints.
- Pooled depression scores (HADS, BDI, PHQ-9) were generally below clinical thresholds for major depressive disorder.
- Regional differences were significant (p=0.002), but age and sex were not associated with depressive symptoms.
Conclusions:
- Depressive symptoms are common in stoma patients, exceeding general population rates.
- While prevalent, depressive symptoms are often sub-clinical, indicating a need for targeted psychological interventions.
- Enhanced perioperative psychological evaluation and care are recommended to improve stoma patient outcomes and psychosocial adjustment.
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