The effect of nutritional management on the mood of malnourished patients.
OBJECTIVE
Starvation and weight loss are common accompaniments of severe illness. The functional consequences of such malnutrition include not only physical changes but also psychological changes such as depression, anxiety, irritability, apathy, poor sleep pattern and loss of concentration. We carried out a pilot observational study in 22 undernourished patients at the time of referral to the nutritional team and after 8 days of nutritional support, using the Profile of Mood States Score (POMS) questionnaire to determine whether measurable and clinically significant changes in mood occurred with treatment.


METHODS
Twenty-two undernourished patients with gastrointestinal disease were studied during the first week of treatment by the nutrition team. Psychological assessment was performed using a structured and standardised questionnaire assessing mood states (tension, depression, anger, vigour, fatigue, confusion). The questionnaire was administered to the patients by the same interviewer on days 1 (start of treatment by the nutrition team) and 8.


RESULTS
Median (IQR) scores for tension, depression, anger, vigour, fatigue and confusion were 21.5 (11.5), 29.0 (15.8), 15.0 (11.8), 6.0 (7.5), 20.0 (8.5) and 12.0 (7.0) respectively on day 1. Corresponding scores on day 8 were 4.0 (8.8), 3.5 (6.0), 1.0 (1.8), 20.0 (7.5), 10.0 (8.8) and 2.5 (6.8). The improvement in scores seen on day 8 was statistically significant (p<0.01).


CONCLUSIONS
Nutritional status and treatment have important effects on the psychology of patients and formal measurements of psychological function will form an important part of nutritional assessment and monitoring in the future.
Stanga
Zeno
Z
Clinical Nutrition and Investigation Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK. zeno.stanga@insel.ch
Field
Joy
J
Iff
Samuel
S
Stucki
Armin
A
Lobo
Dileep N
DN
Allison
Simon P
SP
D000339:Affect; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000523:psychology* / Q000628:therapy*; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D044623:Nutrition Therapy; D009752:Nutritional Status; D018529:Nutritional Support; D011581:Psychological Tests; D011795:Surveys and Questionnaires