title: Prospective Pilot Investigation: Presurgical Depressive Symptom Severity and Anesthesia Response in Women Undergoing Surgery for Gynecologic Mass Removal.
abstract: BACKGROUND
  Anesthesia depth has been associated with mortality. The association between anesthesia depth and presurgery physical and health status, however, is currently debated. Depression is one comorbid condition that warrants investigation given its association to reduced frontal lobe activity and high prevalence in known surgery samples (e.g., gynecologic mass removal).
  
  
  OBJECTIVE
  This pilot study examined the hypothesis that severity of acute depressive symptoms would associate with greater sensitivity to anesthesia as measured by a frontal lobe electroencephalogram (EEG)-based monitor during the anesthesia induction phase among women undergoing gynecologic mass removal.
  
  
  METHODS
  This was a prospective and surgery anesthesia-controlled pilot investigation with 31 women undergoing surgery for removal of pelvic/gynecologic masses. Participants completed the Millon Behavioral Medicine Diagnostic (MBMD) inventory to assess depressive-related symptomatology. A Bispectral Index Score (BIS™) monitor (Aspect Medical Systems Inc., MA) was placed on the left frontal region to measure change in response from a set pre-anesthesia baseline point throughout the induction phase (6.5 min of the anesthetic). BIS™ change was calculated using a modified "area under the curve with respect to ground" formula.
  
  
  RESULTS
  Greater sensitivity to anesthesia during induction was significantly associated with higher MBMD future pessimism scores and marginally associated with higher MBMD depression scores. Depressive personality, anxiety severity, tumor type, age, medication use, and comorbidity scores were not found to be predictors of BIS score change.
  
  
  CONCLUSIONS
  These pilot findings suggest that preoperative psychological health and anesthesia response are not independent. Acute presurgery depression and anesthesia response warrant closer empirical examination.
authors.affiliation: Department of Clinical and Health Psychology, University of Florida, P.O. Box 100165, Gainesville, FL, 32610-0165, USA, cep23@phhp.ufl.edu.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: Price
authors.forename: Deidre B
authors.initials: DB
authors.lastname: Pereira
authors.forename: Rachel
authors.initials: R
authors.lastname: Andre
authors.forename: Cynthia Wilson
authors.initials: CW
authors.lastname: Garvan
authors.forename: Peter
authors.initials: P
authors.lastname: Nguyen
authors.forename: Mary
authors.initials: M
authors.lastname: Herman
authors.forename: Christoph
authors.initials: C
authors.lastname: Seubert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000379:methods*; D001007:Anxiety / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D004569:Electroencephalography; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies