Abstract
Introduction Comorbid major depressive disorder (MDD) is present in up to 25% of chronic rhinosinusitis
(CRS) cases and provides prognostic information for patients undergoing endoscopic
sinus surgery (ESS). Clinical visits offer an opportunity to identify at-risk patients.
Objective The purpose of the present study is to evaluate practice patterns among members of
the American Rhinologic Society (ARS) in screening for/diagnosing MDD.
Methods A 21-question survey was distributed to 1,206 members of the ARS from May 26, 2018
to June 12, 2018. The impact of demographic factors, including hospital setting, fellowship
status, and experience were assessed through chi-squared analysis.
Results A total of 80 members of the ARS completed the survey, yielding a response rate of
7%. Half of the respondents worked in academic settings and 43% had completed a rhinology
fellowship. Twenty percent of the participants felt comfortable diagnosing or managing
MDD, while only 10% of participants screened for MDD in patients with CRS. Respondents
cited a lack of training (76%) and unfamiliarity with diagnostic criteria (76%) as
barriers to the routine assessment of MDD. Most respondents (95%) considered comorbid
psychiatric illness to negatively impact outcomes following ESS. Fellowship-trained
respondents were significantly more likely to implement screening tools in their practice
(p = 0.05), and believe in the negative impact of MDD on postoperative outcomes (p = 0.007), cost of care (p = 0.04) and quality of life (p = 0.047).
Conclusion Amongst ARS members, 95% of the respondents consider comorbid MDD to negatively impact
patient outcomes following ESS. Regardless, a large proportion of surgeons neither
screen nor feel comfortable diagnosing MDD.
Keywords
depression - chronic rhinosinusitis - screen - diagnosis - management - quality of
life
