Original Research Reports Depression Increases the Length of Hospitalization for Patients Undergoing Thoracic Surgery: A Preliminary Study Rieko Kitagawa, M.D., Norio Yasui-Furukori, M.D., Ph.D., Takao Tsushima, M.D., Ph.D., Sunao Kaneko, M.D., Ph.D., Ikuo Fukuda, M.D., Ph.D. Objective: Surgical treatment, especially thoracic sur- gery, is a burdensome prospect for many patients. De- pression-related anxiety, insomnia, and stress are com- mon complaints in preoperative patients. Such depressive complaints are currently thought to affect the patients’ physiological status. We examined the effect of mental status on the length of hospitalization following thoracic surgery. Methods: The study population was comprised of 52 patients (lung cancer 88%) who under- went operative treatment for thoracic disease. Patient depressive status was evaluated using the Self-Rating Depression Scale (SDS) at admission and again at dis- charge. Demographic data were collected retrospec- tively and included age, thoracotomy, and number of days in the hospital. Results: SDS scores did not differ between admission and discharge (37.7  9.9 vs. 40.4  8.9, respectively; ns). The length of hospital- ization in patients with depression (SDS score  40) was significantly greater than for those without depres- sion (P  0.05). The length of hospitalization signifi- cantly correlated with the SDS score at admission (r = 0.492, P  0.001). Multiple regression analyses re- vealed that the length of hospitalization correlated with the SDS score at admission (P  0.01) and with endo- scopic surgery (P  0.05). Conclusion: This study sug- gests that depression increases the length of hospitaliza- tion for malignancy patients undergoing thoracic surgery; early intervention or treatment for depression may be required for these patients to improve outcomes. (Psychosomatics 2011; 52:428 – 432) S urgical treatment, especially thoracic surgery, is a bur- densome prospect for many patients. Anxiety, insom- nia, and stress are common complaints in perioperative patients. Such emotional complaints are currently thought to affect patients’ physiologic status. Although initial de- pression and its related anxiety resolve for most patients, research has shown that some patients experience persis- tent or even worsening depression after coronary artery graft surgery. 1 Therefore, surgeons should be aware of the presence of initial anxiety and depression in patients be- fore surgery. Major depressive disorder is estimated to occur in 10%–25% of patients suffering from cancer, a rate greater than twice the rate in the general population. It has been reported that almost half of cancer patients have been diag- nosed with a psychiatric disorder. 2 Recently, data on 217 cancer patients have indicated that the most common psy- chiatric diagnoses are adjustment disorder (27%), major depression (18%), and delirium (11%). 3 The psychologi- cal burden in patients with a malignancy has gained in- creasing attention through the field of psycho-oncology. Several studies have suggested that depression is associ- ated with increased mortality in cancer patients. Buccheri Received December 26, 2010; revised March 22, 2011; accepted March 25, 2011. From Department of Thoracic and Cardiovascular surgery, Grad- uate School of Medicine, Hirosaki University, Japan (RK, TT, IF); De- partment of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Japan (NY-F, SK). Send correspondence and reprint requests to Norio Yasui-Furukori, M.D., Ph.D., Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki, University, Hirosaki 036-8562, Japan. e-mail: yasufuru@cc.hirosaki-u.ac.jp © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved. Psychosomatics 2011:52:428 – 432 © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved. 428 www.psychosomaticsjournal.org Psychosomatics 52:5, September-October 2011