title: Prevalence and Determinants of Depression and Anxiety Symptoms in Surgical Patients.
abstract: OBJECTIVE
  Mood disorders are prevalent in hospitalized patients. However, risk factors for early diagnosis have not been studied exclusively in surgical patients. Our study aimed to investigate the prevalence and determinants of depression and anxiety symptoms in surgical patients.
  
  
  METHODS
  We included 392 surgical patients in this prospective cross-sectional study, which took place between June 2011 and June 2012. The Hospital Anxiety and Depression Scale (HADS) was used to screen for symptoms of depression and anxiety at weekly interviews. Regression analysis was performed to identify risk factors for early (the day after admission) and late (one week or more) in-hospital psychiatry symptoms.
  
  
  RESULTS
  Depression and anxiety symptoms increased from the time of admission toward longer hospital stay. Scores obtained in the second and third weeks of admission were associated with the need for surgery while HADS in the third week was associated with lack of familial support and being under the poverty line (p < 0.050). Regression model analysis showed that early depression was associated with female gender, and early anxiety was inversely affected by female gender and protected by higher education level. A history of mood disorder was a risk factor. Later anxiety was also associated with longer hospital stay.
  
  
  CONCLUSIONS
  Depression and anxiety symptoms are a major concern in surgical patients especially in females and those with a history of mood disorders or lower educational level. Patients with a longer hospital stay, in particular, those with underlying diseases, postoperative complications, lack of familial support, and the need for reoperation were also at increased risk.
authors.affiliation: Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoar
authors.affiliation: Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Naderan
authors.affiliation: Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Motahareh
authors.initials: M
authors.lastname: Aghajani
authors.affiliation: Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Elaheh
authors.initials: E
authors.lastname: Sahimi-Izadian
authors.affiliation: Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Negin
authors.initials: N
authors.lastname: Hosseini-Araghi
authors.affiliation: Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Improvement of Surgical Outcomes and Procedures, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Zhamak
authors.initials: Z
authors.lastname: Khorgami
keywords: Anxiety; Depression; Hospital Anxiety and Depression Scale; Prevalence; Surgery