Symptoms of anxiety and depression in surgical patients at the hospital, 6 weeks and 6 months postsurgery: A questionnaire study.

This was an observational questionnaire study, so it can show associations but cannot prove that symptoms, sleep or education caused anxiety or depression. Self-reported HADS scores screen for symptoms; they are not a diagnosis of anxiety or depressive disorder. Eligibility partly depended on nurses' subjective assessment of mental capacity and physical state. Only 390 patients were analysed for prediction, and the number for each surgery type was small, so comparisons by surgery type are limited. Comorbidities and psychiatric history were self-reported and not checked against medical records. The study averaged 14 different postoperative symptoms into one distress score, which may hide important individual symptoms. Pain was assessed as average pain over 24 hours, which may not capture severe or constant pain. The date of hospital questionnaire completion was not recorded, so day 1 to 3 answers may vary. No intervention was tested, so the findings do not show that screening or symptom management improves outcomes.

The authors declared no conflicts of interest. No funder is named in the supplied text.

Do not conclude that screening, education or symptom management will reduce postoperative anxiety or depression. The study measured associations in self-reported symptoms and did not test an intervention.