Diagnosis and Management of Depression in CRS: A Knowledge, Attitudes and Practices Survey
Introduction Comorbid major depressive disorder (MDD) is present in up to 25% of chronic rhinosinusitis (CRS) cases and provides prognostic information for patients undergoing endoscopic sinus surgery (ESS). Clinical visits offer an opportunity to identify at-risk patients.
Objective The purpose of the present study is to evaluate practice patterns among members of the American Rhinologic Society (ARS) in screening for/diagnosing MDD.
Methods A 21-question survey was distributed to 1,206 members of the ARS from May 26, 2018 to June 12, 2018. The impact of demographic factors, including hospital setting, fellowship status, and experience were assessed through chi-squared analysis.
Results A total of 80 members of the ARS completed the survey, yielding a response rate of 7%. Half of the respondents worked in academic settings and 43% had completed a rhinology fellowship. Twenty percent of the participants felt comfortable diagnosing or managing MDD, while only 10% of participants screened for MDD in patients with CRS. Respondents cited a lack of training (76%) and unfamiliarity with diagnostic criteria (76%) as barriers to the routine assessment of MDD. Most respondents (95%) considered comorbid psychiatric illness to negatively impact outcomes following ESS. Fellowship-trained respondents were significantly more likely to implement screening tools in their practice (p = 0.05), and believe in the negative impact of MDD on postoperative outcomes (p = 0.007), cost of care (p = 0.04) and quality of life (p = 0.047).
Conclusion Amongst ARS members, 95% of the respondents consider comorbid MDD to negatively impact patient outcomes following ESS. Regardless, a large proportion of surgeons neither screen nor feel comfortable diagnosing MDD.
Eingereicht: 22. Juni 2019
Angenommen: 03. Dezember 2019
24. April 2020 (online)
© 2020. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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- 1 Zhou S, Hur K, Shen J, Wrobel B. Impact of sinonasal disease on depression, sleep duration, and productivity among adults in the United States. Laryngoscope Investig Otolaryngol 2017; 2 (05) 288-294
- 2 Litvack JR, Mace J, Smith TL. Role of depression in outcomes of endoscopic sinus surgery. Otolaryngol Head Neck Surg 2011; 144 (03) 446-451
- 3 Davis GE, Yueh B, Walker E, Katon W, Koepsell TD, Weymuller EA. Psychiatric distress amplifies symptoms after surgery for chronic rhinosinusitis. Otolaryngol Head Neck Surg 2005; 132 (02) 189-196
- 4 Schlosser RJ, Gage SE, Kohli P, Soler ZM. Burden of illness: A systematic review of depression in chronic rhinosinusitis. Am J Rhinol Allergy 2016; 30 (04) 250-256
- 5 Schlosser RJ, Hyer JM, Smith TL. et al. Depression-Specific Outcomes After Treatment of Chronic Rhinosinusitis. JAMA Otolaryngol Head Neck Surg 2016; 142 (04) 370-376
- 6 Schlosser RJ, Storck K, Cortese BM, Uhde TW, Rudmik L, Soler ZM. Depression in chronic rhinosinusitis: A controlled cohort study. Am J Rhinol Allergy 2016; 30 (02) 128-133
- 7 Erskine SE, Hopkins C, Clark A. et al. Chronic rhinosinusitis and mood disturbance. Rhinology 2017; 55 (02) 113-119
- 8 Wasan A, Fernandez E, Jamison RN, Bhattacharyya N. Association of anxiety and depression with reported disease severity in patients undergoing evaluation for chronic rhinosinusitis. Ann Otol Rhinol Laryngol 2007; 116 (07) 491-497
- 9 Hanna BM, Crump RT, Liu G, Sutherland JM, Janjua AS. Incidence and burden of comorbid pain and depression in patients with chronic rhinosinusitis awaiting endoscopic sinus surgery in Canada. J Otolaryngol Head Neck Surg 2017; 46 (01) 23
- 10 Tomoum MO, Klattcromwell C, DelSignore A, Ebert C, Senior BA. Depression and anxiety in chronic rhinosinusitis. Int Forum Allergy Rhinol 2015; 5 (08) 674-681
- 11 Cox DR, Ashby S, DeConde AS. et al. Dyad of pain and depression in chronic rhinosinusitis. Int Forum Allergy Rhinol 2016; 6 (03) 308-314
- 12 Young AK, Young BK, Riley III LH, Skolasky RL. Assessment of presurgical psychological screening in patients undergoing spine surgery: use and clinical impact. J Spinal Disord Tech 2014; 27 (02) 76-79
- 13 Goldin Evans M, Phillippi S, Gee RE. Examining the Screening Practices of Physicians for Postpartum Depression: Implications for Improving Health Outcomes. Womens Health Issues 2015; 25 (06) 703-710
- 14 Adams KN, Schuman TA, Ebert CS, You W, Tomoum MO, Senior BA. Self-reported anxiety and depression unchanged after endoscopic sinus surgery for chronic rhinosinusitis. Rhinology 2018; 56 (03) 234-240
- 15 Banoub RG, Hoehle LP, Phillips KM. et al. Depressed Mood Modulates Impact of Chronic Rhinosinusitis Symptoms on Quality of Life. J Allergy Clin Immunol Pract 2018
- 16 Gilbody S, Richards D, Brealey S, Hewitt C. Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): a diagnostic meta-analysis. J Gen Intern Med 2007; 22 (11) 1596-1602
- 17 El-Den S, Chen TF, Gan YL, Wong E, O'Reilly CL. The psychometric properties of depression screening tools in primary healthcare settings: A systematic review. J Affect Disord 2018; 225: 503-522
- 18 Chen S, Le CH, Liang J. Practice patterns in endoscopic dacryocystorhinostomy: survey of the American Rhinologic Society. Int Forum Allergy Rhinol 2016; 6 (09) 990-997
- 19 Respondent Fatigue PB-N. In: PJ L, ed. Encyclopedia of Survey Research Methods. 2008: 742-743