Psychiatric insights in thoracic surgery for adults and children: A narrative review

Thoracic surgery, encompassing procedures on the lungs, esophagus, mediastinum, and chest wall, carries substantial psychiatric implications that influence outcomes, recovery, and long-term quality of life in adult and pediatric patients. This review synthesizes global evidence on the prevalence and clinical relevance of mental health issues throughout the perioperative period. In adults, preoperative anxiety and depression correlate with increased complications and readmissions, supporting routine screening and optimization of modifiable factors such as substance use and sleep disorders. Postoperatively, priorities include delirium prevention and management of post traumatic stress disorder and body-image distress, especially after extensive resections. Pediatric care demands tailored strategies, focusing on separation anxiety, perioperative preparation with child-life specialists, and recognition of emergence delirium. Overall, integrating psychiatry and enhanced recovery after surgery protocols that address mental health is essential for recovery.