Psychological factors, immune function and recovery from major surgery.

Abstract:

OBJECTIVE:This study used a prospective design and the technique of structural modelling to examine the complex interrelations between psychological factors, immune status and complications after major surgery. METHODS:Twenty-nine women scheduled for elective cholecystectomy were studied prospectively. Information regarding medical history, health practices, life stressors, and coping strategies was obtained two weeks prior to admission. At this initial meeting, as well as three days after surgery, and at one month follow-up immunological tests were performed and the level of psychological distress was assessed. The study additionally included measures of post-operative complications, and infections and negative effect during follow-up. RESULTS:Pre-operative immune status emerged as a key variable exerting strong effects on subsequent immune function and, thereby producing significant, indirect effects on every recovery variable. Pre-operative distress was directly linked to increased mood disturbance at follow-up. Moreover, distress significantly influenced immune function both before and after surgery, which mediated a significant impact on most recovery variables. Active coping behaviour directly increased the risk of a complicated recovery. CONCLUSIONS:The study demonstrated that distress-induced changes in immune functioning have clinical relevance. Overall, the present findings suggest that recovery from surgery is facilitated in patients with a well-functioning immune system, a low-level of pre-operative distress and a passive coping disposition.

journal_name

Acta Neuropsychiatr

journal_title

Acta neuropsychiatrica

authors

Vollmer-Conna U,Bird KD,Yeo BW,Truskett PG,Westbrook RF,Wakefield D

doi

10.1111/j.1601-5215.2009.00398.x

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

169-78

issue

4

eissn

0924-2708

issn

1601-5215

pii

S0924270800001198

journal_volume

21

pub_type

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