Study: Psychological preparation for surgery is as important as physical preparation

Ignoring patients’ mental health before major surgery can slow their recovery, particularly among older adults, according to a new study published Wednesday in JAMA Network Open.

“Stress associated with surgery can increase anxiety and symptoms of depression, as well as affect patients’ recovery and overall health,” said the study’s first author, Joanna Abraham.

The authors argue that preoperative preparation should include not only physical but also psychological support from trained mental health professionals — something that is often lacking in current perioperative care.

“We understand how important it is to get the body in shape before surgery, but preparing the mind and brain is no less important,” said senior study author Eric J. Lenz.

The next step is a “comprehensive” approach to patients, added Michael S. Avidan, which would involve bringing together anesthesiology and psychiatry, Euronews reports.

The study involved 306 people aged 60 and older who were scheduled to undergo cardiac, cancer, or orthopedic surgery. The patients were divided into two groups. One group received only self-help materials to study independently, while the other held conversations with a trained mental health professional — such as a social worker or mental health counselor — during 8 to 12 telephone sessions. The second group also underwent a personalized medication review with pharmacists and physicians to safely optimize doses of medications associated with a high risk of side effects.

Three months after surgery, patients who had spoken with mental health professionals and undergone medication reviews showed a 2.2–2.5-point greater reduction in symptoms of depression and anxiety than those who received only educational materials, based on a 48-point scale.

The greatest effect was observed among older patients who had undergone cancer surgery: their mental health scores were nearly five points lower than those of the control group.

Patients also reported positive experiences with the additional support, both from mental health professionals and pharmacists who helped reduce unnecessary medications.

“The promise of this model of care is that it really can be implemented in practice,” Abraham said. “Patients and healthcare staff found the program manageable and easy to integrate into existing surgical processes. Proactive mental health care does not necessarily have to become an additional burden for the hospital.”