This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Mertens, M. C. Articles by De Vries, J. PubMed PubMed Citation Articles by Mertens, M. C. Articles by De Vries, J. Related Collections Personality Anxiety

Trait Anxiety Predicts Unsuccessful Surgery in Gallstone Disease

From the CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical Psychology (M.C.M., J.A.R., J.D.V.), Tilburg University, Tilburg, Netherlands; Departments of Surgery (J.A.R.) and Medical Psychology (J.D.V.), St. Elisabeth Hospital, Tilburg, Netherlands; and the Department of Surgery (V.P.W.S.), St. Antonius Hospital, Nieuwegein, Netherlands.

Address correspondence and reprint requests to: J. de Vries, CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical Psychology and Neuropsychology, Tilburg University, Warandelaan 2, 5037 AB, Netherlands. E-mail: j.devries{at}uvt.nl

Objective: To identify predictors of negative symptomatic outcomes at 6 months after cholecystectomy, surgical removal of the gallbladder, which is the preferred treatment for gallstone disease. After cholecystectomy, a substantial number of patients report persistence of symptoms.

Methods: In this prospective follow-up study, consecutive patients (n = 172) diagnosed with symptomatic gallstone disease and indicated for elective cholecystectomy were investigated. Preoperatively and at 6 months, patients completed self-report symptom checklists. The Spielberger State-Trait Anxiety Inventory scale was completed preoperatively and patients with a score of P 80 were considered having High Trait Anxiety (HTA). Multivariate regression analyses were used to investigate independent predictors of persisting symptoms.

Results: Six months after cholecystectomy, patients with HTA were more likely to report persisting biliary symptoms than patients without HTA (NHTA) (45.5% versus 14.3%; ² = 8.78, p = .002). HTA was identified as an independent predictor of persisting biliary symptoms at 6 months (odds ratio [OR], 3.08, p = .047; 95% confidence interval [CI], 1.02–9.34), in addition to the report of nonspecific symptoms (OR, 6.16, p = .024; 95% CI, 1.27–29.82), and the use of psychotropic medication (OR, 4.76, p = .023; 95% CI, 1.24–18.34).

Conclusion: Patients with HTA have a three times higher risk at persisting biliary symptoms at 6 months after cholecystectomy than NHTA patients. Both clinical factors and the patient’s personality should be considered in clinical decision making and risk estimation in elective cholecystectomy.

Key Words: personality • trait anxiety • gallstone disease • surgery • recovery • cholecystectomy

Abbreviations: STAI = Spielberger State-Trait Anxiety Inventory; TA = Trait Anxiety; HTA = High Trait Anxiety (STAI-trait P80); NHTA = Nonhigh Trait Anxiety (STAI-trait P79); VAS = Visual Analogue Scale.