Surgical patients with chronic psychological symptoms require psychotherapeutic treatment

In their study, the research group, headed by Privatdozent Dr. Henning Krampe, psychologist at the Charité Department of Anesthesiology and Intensive Care Medicine, Prof. Claudia Spies, Director of the Charité Department of Anesthesiology and Intensive Care Medicine and Prof. Elmar Brähler, Head of the Department of Medical Psychology and Medical Sociology at the University of Leipzig, initially recorded how many patients faced by a forthcoming operation were interested in psychotherapy sessions and to what extent this interest was associated with the increased psychological distress occurring before the operation. Finally, the scientists examined whether changes in the psychological symptoms took place during the six months following the surgery.

"It is striking how persistently high depression, anxiety, general psychological symptoms and alcohol problems remained for patients with an interest in psychotherapy - even six months after the surgery", states Privatdozent Dr. Henning Krampe, leader of the BRIA project (Bridging Intervention in Anesthesiology) at the Charité Department of Anesthesiology and Intensive Care Medicine. "This stability of distress in a wide range of psychological disorders would suggest that it is not a question of temporary worries and stress due to the operation, but rather of chronic psychological symptoms requiring psychotherapeutic treatment."

It is necessary - both from a psychotherapeutic and medical perspective - to treat the psychological disorders of surgical patients. Depression, anxiety and addiction, if left untreated, contribute to surgical complications as well as to a worse recovery after the operation. In this manner, they promote overall a less favourable course of the medical disease through to a higher mortality rate.

"In further investigations we were able to show that over 30 percent of the surgical patients suffer from clinically significant depression, and that elevated depression in these patients represents an important risk factor for a longer stay in hospital", explains Prof. Claudia Spies. "The objective of the BRIA programme developed by us in 2009 is to detect, diagnostically determine and effectively treat the psychological symptoms of surgical patients. From a long-term perspective, this approach contributes to enhancing the overall quality of life and to improve recovery of the medical diseases of our patients."

In BRIA, the researchers of the interdisciplinary project have developed a new therapy programme, which begins with a short computer-aided questionnaire survey before the operation and immediate feedback on the results of the survey. By this means, it is possible for the patients to receive psychotherapeutic motivational interventions, comprehensive psychological diagnostics and supportive therapy while still in hospital. "In the end, patients with diagnosed psychological disorders and interest in therapy receive individually designed psychotherapeutic bridging sessions which help them to find effective access as quickly as possible to long-term psychosocial therapy options of routine health care", explains Henning Krampe. An initial clinical study showed that the stepped-care approach of BRIA can be successfully integrated into the context of anesthesiological and surgical hospital care.



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