This research was made possible by a grant from the NIH/NIDCD #R01 DC005805 and support from the Master of Public Health graduate program within the Department of Public Health and Preventive Medicine at Oregon Health & Science University.
Effects of Depression on Quality of Life Improvement After Endoscopic Sinus Surgery†
Article first published online: 2 JAN 2009
Copyright © 2008 The Triological Society
Volume 118, Issue 3, pages 528–534, March 2008
How to Cite
Mace, J., Michael, Y. L., Carlson, N. E., Litvack, J. R. and Smith, T. L. (2008), Effects of Depression on Quality of Life Improvement After Endoscopic Sinus Surgery. The Laryngoscope, 118: 528–534. doi: 10.1097/MLG.0b013e31815d74bb
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Manuscript Accepted: 8 OCT 2007
- Endoscopic sinus surgery;
- quality of life;
- chronic rhinosinusitis
Objectives/Hypothesis: To determine whether self- reported depression predicts lesser postoperative improvement in health-related quality of life (HRQoL) after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).
Study Design: Prospective open cohort.
Methods: An adult (≥18 yr) cohort of 23 patients with depression and 79 patients without depression undergoing ESS were followed for 12 ± 2 months. Patient characteristics and computed tomography scores were examined preoperatively. Endoscopy scores and two HRQoL measures, the Rhinosinusitis Disability Index (RSDI) and Chronic Sinusitis Survey, were analyzed pre- and postoperatively. Univariate and multivariate analyses were used to evaluate outcome differences for patients with depression.
Results: There was a significantly higher prevalence of women (P = .002) and longer duration of follow-up (P = .004) for the depressed subgroup. Depressed patients reported significantly lower pre- and postoperative HRQoL scores on all RSDI subscales (P < .05). Without baseline adjustment, depression was not associated with significant differences in postoperative change for disease-specific HRQoL scores (P > .10) in multivariate analysis.
Conclusions: Depressed patients with CRS present similarly but have worse pre- and postoperative HRQoL scores and experience similar disease-specific QoL improvements from sinus surgery compared with other CRS patients. Sinus surgery is not effective in alleviating the effect of depression on disease-specific HRQoL, and it is likely that comorbid depression and CRS are operating on independent disease pathways. Additional research and hypothesis testing using continuous, objective measures is warranted.