Screening tool detects anxiety in half of children going into surgery
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Key takeaways:
- Researchers used the KCAT computerized adaptive mental health screening program to test children for preoperative anxiety and depression.
- One-third of patients had depression, and more than half had anxiety.
A brief, computerized mental health screening for children going into surgery showed that more than half were experiencing preoperative anxiety, according to findings presented at Anesthesiology 2024.
“The main purpose of the study was to determine the feasibility of administering a pediatric-specific, computerized adaptive mental health assessment tool (KCAT) on pediatric surgical patients,” Sarah Nizamuddin, MD, associate professor of anesthesia and critical care at University of Chicago Medicine, told Healio. “We found that it was feasible and easy to administer this tool in the preoperative area.”
Nizamuddin said the KCAT tool was developed by Robert Gibbons, PhD, a professor of statistics at the University of Chicago, to screen children and adolescents aged 7 to 17 years for mental health disorders like depression, anxiety, ADHD and mania, among others.
“This tool makes anxiety and depression screening possible in a rapid fashion without the need of an experienced interviewer,” she said.
Nizamuddin and colleagues used the tool to screen 65 children and adolescents (mean age, 13 years; range, 7 to 18 years) for anxiety and depression before undergoing surgery.
Screening took an average of 2 minutes and 13 seconds (range, 0:54 to 6:29), the researchers found. One-third of patients tested positive for mild (25%), moderate (6%) or severe (3%) depression, and more than half tested positive for mild (43%), moderate (9%) or severe (5%) anxiety.
Having a prior diagnosis of anxiety significantly increased patients’ risk for anxiety (RR = 1.78; 95% CI, 1.43-2.2) or depression (RR = 3.05; 95% CI, 2.14-4.33) before surgery. Other preoperative conditions — revision surgery, requiring daily assistance, depression, autism, ADHD, cancer — and being female were associated with higher relative risk for anxiety and depression, but none were statistically significant, the researchers wrote.
“Using this tool to identify preoperative anxiety and/or depression will allow the patient’s care team to individualize management of these mental health issues preoperatively, intraoperatively and postoperatively and focus resources on patients that could have the most benefit,” Nizamuddin said. “For example, if a child is discovered to have severe preoperative anxiety through their KCAT score, anesthesia providers can utilize the help of child life specialists, preoperative anxiolytics and other anxiety-reducing techniques to personalize the plan for the patient and to help improve their experience.”
“While it is not unexpected to have anxiety prior to a procedure, more research is needed to inquire how the anxiety and depression screens change at different time points before and after surgical procedures,” she said.
References:
- Easy-to-use tool helps screen for anxiety, depression in children having surgery. https://www.eurekalert.org/news-releases/1061267. Published Oct. 20, 2024. Accessed Nov. 6, 2024.
- Gibbons RD, et al. J Am Acad Child Adolesc Psychiatry. 2024;doi:10.1016/j.jaac.2019.08.009.
- Nizamuddin S, et al. Abstract A3279. Presented at: Anesthesiology 2024. Oct. 18-22, 2024; Philadelphia.
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Nizamuddin S, et al. Abstract A3279. Presented at: Anesthesiology 2024. Oct. 18-22, 2024; Philadelphia.
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