Psychological distress before and after surgical resection of benign orofacial tumors: a prospective study

Abstract Purpose To evaluate the presence and level of psychological distress in subjects before and after resection of benign orofacial tumors, and to identify the variables that are associated with this psychological distress. Methods This study made use of the Hospital Anxiety and Depression Scale and the Rosenberg Self Esteem Scale. A questionnaire made up of these two scales was administered to subjects before surgery, one week, two weeks, and six weeks after surgery. The scores at the various intervals were statistically compared, and the relationships between variables (age, sex, education, marital status, occupation, size of lesion) and psychological distress were also tested. Results Twenty-nine percent of the subjects showed abnormal levels of anxiety before surgery, while 12.9% reported abnormal depression levels before surgery. At one week, two weeks, and six weeks after surgery, the proportion of subjects with abnormal anxiety levels rose from 29.0% before surgery to 38.7, 38.7, and 35.5%, respectively. The proportion of subjects with abnormal depression levels at all intervals after surgery remained the same as before surgery (12.9%). All subjects had normal self-esteem levels both before and after surgery. Using a paired t-test, mean anxiety scores at all intervals after surgery were significantly higher than mean anxiety score before surgery. Analyses of the relationships between independent variables and psychological distress (anxiety and depression) found level of education to be significantly associated with anxiety before and after surgery. In contrast, size of lesion was significantly associated with depression both before and after surgery. Conclusion The results of this study suggest that abnormal anxiety and depression are present in some patients with benign orofacial tumors both before and after surgery. Patients’ level of education, and size of the lesion are strongly associated with the level of psychological distress seen in patients with benign orofacial tumors.