A new, automated mental health assessment tool could allow doctors to quickly identify children experiencing anxiety or depression before surgery, new research presented at the ANESTHESIOLOGY Annual Meeting 2024. In the small, single-center study, researchers found that more than half of the children screened had anxiety before surgery and more than a third had depression.
“Use of the KCAT (Knowledge and Competency Assessment Tool) instrument in pediatric patients in the preoperative setting is highly feasible and the results of our pilot study demonstrate a substantial prevalence of these mental health conditions in this surgical population,” said Elizabeth Pealy, MD, lead author of the study and assistant professor of anesthesia and critical care at the University of Chicago Medicine.
“Anxiety and depression are caused by many factors. Many children are anxious before undergoing surgery and the stress of undergoing the actual procedure can accentuate this.”
The overall incidence and prevalence of childhood anxiety and depression in the United States has increased dramatically in recent years. It is difficult for pediatric anesthesiologists to determine whether patients have undiagnosed anxiety or depression prior to surgery, or severe preoperative anxiety.
Increased anxiety may contribute to child non-compliance during induction of anesthesia, but may also lead to prolonged recovery, increased postoperative pain and delirium, and decreased patient satisfaction. Because thousands of children undergo surgery every year, a comprehensive but rapid method to screen for these conditions is needed.
In the study, researchers tested the feasibility of administering KCAT – a computerized adaptive mental health assessment tool – to pediatric surgical patients in the preoperative waiting area and examined the prevalence of anxiety and depression in this group. According to the authors, KCAT allows rapid and accurate assessment of anxiety and depression without the need for a trained clinical interviewer. It is administered on a tablet and allows real-time assessment in the perioperative setting.
Sixty-five children requiring elective surgery at a large children’s hospital were enrolled. The mean age was 13 years (range 7 to 18 years). All children completed the test (which took an average of two minutes and thirteen seconds), with 15 children receiving parental assistance. The researchers found that 57% of patients screened positive for anxiety and 34% of patients screened positive for depression.
“This is the first study to examine the use of this device in children in this setting,” says Sarah Nizamuddin, MD, co-author of the study and associate professor of anesthesia and critical care at the University of Chicago Medicine.
“The ability to quickly assess and record anxiety and depression levels may allow healthcare providers to offer a variety of anxiety-reducing options before and after surgery to the patients who would benefit most. Further research should focus on determining how to use the information to better meet the needs of pediatric patients to improve their surgical experience.”
Provided by American Society of Anesthesiologists
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