Easy-to-use tool helps screen for anxiety, depression in children having surgery

A new, computerized, mental health assessment tool may allow doctors to quickly identify children experiencing anxiety or depression before surgery, suggests new research presented at the ANESTHESIOLOGY 2024 annual meeting. In the small, single-center study, researchers found more than half of the children screened had anxiety before having surgery and more than one-third had depression.

“The use of the KCAT (Knowledge and Competency Assessment Tool) tool in pediatric patients in the preoperative setting is very feasible and the results of our pilot study show a substantial prevalence of these mental health conditions in this surgical population,” said Elizabeth Pealy, M.D., 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 kids are anxious before having surgery and the stress of undergoing the actual procedure can accentuate it.”

The overall incidence and prevalence of anxiety and depression in children in the United States has dramatically increased in recent years. It is difficult for pediatric anesthesiologists to determine if patients have undiagnosed anxiety or depression, or severe preoperative anxiety, prior to the surgery.

Increased anxiety can contribute to the child being uncooperative during the anesthetic induction, as well as prolonged recovery, increased postoperative pain and delirium, and decreased patient satisfaction. With thousands of children undergoing surgery every year, having a comprehensive yet quick 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—on pediatric surgical patients in the preoperative holding area and examined the prevalence of anxiety and depression in this group. According to the authors, KCAT allows for quick and accurate assessment of anxiety and depression without the need for a trained clinician interviewer. It is administered on a tablet device and allows for real-time assessment in the perioperative setting.

Sixty-five children scheduled for elective surgery at a large children’s hospital were enrolled. The median age was 13 years old (range 7–18 years). All of the children completed the assessment (taking an average of two minutes and 13 seconds), with 15 receiving parental assistance. The researchers found 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 tool on children in this setting,” said Sarah Nizamuddin, M.D., co-author of the study and associate professor of anesthesia and critical care at the University of Chicago Medicine.

“The ability to rapidly assess for and capture anxiety and depression levels can allow providers to offer a variety of anxiety-reducing options prior to and after surgery to the patients who would benefit the most. Further studies should aim to determine how to use the information to better cater to the needs of pediatric patients to improve their experience during surgery.”

Provided by
American Society of Anesthesiologists