Background: The interaction of depression and anesthesia and surgery may result in significant increases in\nmorbidity and mortality of patients. Major depressive disorder is a frequent complication of surgery, which may\nlead to further morbidity and mortality.\nLiterature search: Several electronic data bases, including PubMed, were searched pairing ââ?¬Å?depressionââ?¬Â with\nsurgery, postoperative complications, postoperative cognitive impairment, cognition disorder, intensive care unit,\nmild cognitive impairment and Alzheimerââ?¬â?¢s disease.\nReview of the literature: The suppression of the immune system in depressive disorders may expose the patients\nto increased rates of postoperative infections and increased mortality from cancer. Depression is commonly\nassociated with cognitive impairment, which may be exacerbated postoperatively. There is evidence that acute\npostoperative pain causes depression and depression lowers the threshold for pain. Depression is also a strong\npredictor and correlate of chronic post-surgical pain. Many studies have identified depression as an independent\nrisk factor for development of postoperative delirium, which may be a cause for a long and incomplete recovery\nafter surgery. Depression is also frequent in intensive care unit patients and is associated with a lower health-related\nquality of life and increased mortality. Depression and anxiety have been widely reported soon after coronary artery\nbypass surgery and remain evident one year after surgery. They may increase the likelihood for new coronary artery\nevents, further hospitalizations and increased mortality. Morbidly obese patients who undergo bariatric surgery have\nan increased risk of depression. Postoperative depression may also be associated with less weight loss at one year\nand longer. The extent of preoperative depression in patients scheduled for lumbar discectomy is a predictor of\nfunctional outcome and patientââ?¬â?¢s dissatisfaction, especially after revision surgery. General postoperative mortality is\nincreased.\nConclusions: Depression is a frequent cause of morbidity in surgery patients suffering from a wide range of\nconditions. Depression may be identified through the use of Patient Health Questionnaire-9 or similar instruments.\nCounseling interventions may be useful in ameliorating depression, but should be subject to clinical trials.
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