title: The relationship of preoperative distress to endocrine and subjective responses to surgery: support for Janis' theory.
abstract: To test Janis' theory that preoperative worry can improve postoperative recovery, endocrine and subjective responses were measured in 27 patients undergoing major abdominal surgery which entailed threat to their health or longevity. Questionnaires to assess emotional and somatic state were completed preoperatively and for 7 days postoperatively. Plasma cortisol, noradrenaline, adrenaline, and glucose were measured pre-, per-, and postoperatively. Preoperatively, noradrenaline correlated positively with pain and distress, and adrenaline negatively. Postoperatively, endocrine levels and distress were not clearly related. Nevertheless, preoperative pain negatively correlated with postoperative adrenaline and cortisol levels. This, and the negative correlation between preoperative distress and postoperative pain are consistent with Janis' theory. In addition, we found that the longer patients waited on the day of surgery, the greater were the cortisol, noradrenaline, and glucose responses.
authors.affiliation: Department of Psychology, University College London, U.K.
authors.forename: P
authors.initials: P
authors.lastname: Salmon
authors.forename: S
authors.initials: S
authors.lastname: Pearce
authors.forename: C C
authors.initials: CC
authors.lastname: Smith
authors.forename: A
authors.initials: A
authors.lastname: Heys
authors.forename: A
authors.initials: A
authors.lastname: Manyande
authors.forename: N
authors.initials: N
authors.lastname: Peters
authors.forename: J
authors.initials: J
authors.lastname: Rashid
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001143:Arousal / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism; D003082:Colectomy / Q000523:psychology; D003125:Colostomy / Q000523:psychology; D004837:Epinephrine / Q000097:blood*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007081:Ileostomy / Q000523:psychology; D007410:Intestinal Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood* / Q000523:psychology; D012803:Sick Role / Q000502:physiology
chemical_list: D001786:Blood Glucose; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine