title: Depressive Symptoms and Risk of Postoperative Delirium.
abstract: OBJECTIVE
  Previous studies have shown that elevated depressive symptoms are associated with increased risk of postoperative delirium. However, to our knowledge no previous studies have examined whether different components of depression are differentially predictive of postoperative delirium.
  
  
  METHODS
  One thousand twenty patients were screened for postoperative delirium using the Confusion Assessment Method and through retrospective chart review. Patients underwent cognitive, psychosocial, and medical assessments preoperatively. Depression was assessed using the Geriatric Depression Scale-Short Form.
  
  
  RESULTS
  Thirty-eight patients developed delirium (3.7%). Using a factor structure previously validated among geriatric medical patients, the authors examined three components of depression as predictors of postoperative delirium: negative affect, cognitive distress, and behavioral inactivity. In multivariate analyses controlling for age, education, comorbidities, and cognitive function, the authors found that greater behavioral inactivity was associated with increased risk of delirium (OR: 1.95 [1.11, 3.42]), whereas negative affect (OR: 0.65 [0.31, 1.36]) and cognitive distress (OR: 0.95 [0.63, 1.43]) were not.
  
  
  CONCLUSIONS
  Different components of depression are differentially predictive of postoperative delirium among adults undergoing noncardiac surgery.
authors.affiliation: Psychiatry and Behavioral Sciences, Division of Medical Psychology, Duke University Medical Center, Durham, NC. Electronic address: Patrick.j.smith@dm.duke.edu.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Smith
authors.affiliation: Psychiatry and Behavioral Sciences, Division of Medical Psychology, Duke University Medical Center, Durham, NC; Department of Neurology, Duke University Medical Center, Durham, NC.
authors.forename: Deborah K
authors.initials: DK
authors.lastname: Attix
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Missouri-Columbia, Columbia, MO.
authors.forename: B Craig
authors.initials: BC
authors.lastname: Weldon
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Missouri-Columbia, Columbia, MO.
authors.forename: Terri G
authors.initials: TG
authors.lastname: Monk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000150:complications* / Q000523:psychology*; D003863:Depression / Q000150:complications* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000523:psychology*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Delirium; behavioral inactivity; depression; negative affect