title: Psychiatric screening for patients with faecal incontinence or chronic constipation referred for surgical treatment.
abstract: Fifty patients attending for surgical treatment of chronic constipation (n = 21) or faecal incontinence (n = 29) were studied using two psychiatric screening tests: the Hospital Anxiety and Depression (HAD) scale and the General Health Questionnaire (GHQ). Each patient was assessed preoperatively and 6-12 months postoperatively. Results were compared with age and sex-matched controls (n = 50). Constipated patients had significantly higher HAD depression scores compared with controls (median and range): 6 (2-12) versus 4 (0-8), P less than 0.05. Constipated patients who were improved by operation (n = 13) had significantly lower preoperative HAD anxiety scores compared with those who were not improved (n = 8): 8 (3-14) versus 15 (10-19), P less than 0.01; they also had significantly lower HAD depression scores: 4 (2-12) versus 7 (5-11), P less than 0.05. Using these parameters incontinent patients did not differ from controls, but patients who had a bad result after operation (n = 15) had significantly higher HAD anxiety scores than those who obtained clinical benefit (n = 14): 10 (2-15) versus 6 (2-12), P less than 0.05; HAD depression scores were also greater: 5 (2-15) versus 3 (0-9), P less than 0.05; and GHQ scores were greater: 12 (0-47) versus 4 (0-41), P less than 0.05.
authors.affiliation: Department of Surgery, General Hospital, Birmingham, UK.
authors.forename: S E
authors.initials: SE
authors.lastname: Fisher
authors.forename: K
authors.initials: K
authors.lastname: Breckon
authors.forename: H A
authors.initials: HA
authors.lastname: Andrews
authors.forename: M R
authors.initials: MR
authors.lastname: Keighley
mesh_terms: D001007:Anxiety / Q000150:complications / Q000175:diagnosis; D002908:Chronic Disease; D003248:Constipation / Q000150:complications / Q000523:psychology* / Q000601:surgery; D003863:Depression / Q000150:complications / Q000175:diagnosis; D005242:Fecal Incontinence / Q000150:complications / Q000523:psychology* / Q000601:surgery; D006801:Humans; D010555:Personality Inventory; D011379:Prognosis; D011446:Prospective Studies; D011594:Psychometrics; D013997:Time Factors