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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2021; 25(01): e48-e53
DOI: 10.1055/s-0040-1701268
Original Research

Diagnosis and Management of Depression in CRS: A Knowledge, Attitudes and Practices Survey

Amarbir S. Gill
1   Department of Otolaryngology – Head and Neck Surgery, University of California, Davis School of Medicine, Sacramento, California, United States
,
Joshua M. Levy
2   Emory University Department of Otolaryngology – Head and Neck Surgery, Atlanta, GA
,
Machelle Wilson
3   Department of Public Health Sciences/Biostatistics, Clinical and Translational Science Center, University of California Davis, Sacramento, CA
,
E. Bradley Strong
1   Department of Otolaryngology – Head and Neck Surgery, University of California, Davis School of Medicine, Sacramento, California, United States
,
Toby O. Steele 
1   Department of Otolaryngology – Head and Neck Surgery, University of California, Davis School of Medicine, Sacramento, California, United States
4   VA Northern California Healthcare System, Sacramento, CA
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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


Publication History

Received: 22 June 2019

Accepted: 03 December 2019

Article published online:
24 April 2020

© 2020. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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