Depression’s Impact on Surgical Outcomes: New Insights from Abdominal Cancer Cases
In an emerging area of medical research, mental health is increasingly recognized as a critical factor influencing physical health outcomes. A recent study presented at the American College of Surgeons (ACS) Clinical Congress 2025 in Chicago sheds new light on how depression affects surgical recovery specifically in older adults undergoing cancer surgeries. This groundbreaking research, conducted by scientists at The Ohio State University and its Wexner Medical Center, focuses on the intersection of depression with colorectal, hepatobiliary, and pancreatic cancer surgeries. The findings offer compelling evidence that depression not only complicates recovery but that effective treatment with antidepressants can substantially improve postoperative outcomes and reduce healthcare costs.
Depression, a pervasive psychiatric disorder characterized by persistent sadness, loss of interest, and impaired cognitive function, has been long associated with adverse physical health effects, including disrupted sleep patterns, weakened immune function, and increased susceptibility to chronic diseases. The relationship between depression and cancer has been an active topic of investigation, with studies linking depression to heightened cancer risk and poorer disease prognosis. However, its specific influence on surgical outcomes has remained less explored until now.
The study utilizes extensive retrospective analysis using data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. By reviewing records of older patients diagnosed with colorectal, hepatobiliary, and pancreatic cancers, the researchers aimed to understand how a concurrent diagnosis of depression, within a 12-month window before or after cancer diagnosis, impacted post-surgical recovery. An important methodological innovation was the use of Medicare Part D prescription data to identify which patients had received antidepressant medications, enabling a distinction between treated and untreated depression in the surgical context.
The research cohort consisted of 32,726 patients, of which 1,731 were diagnosed with depression. Among these, 1,253 patients were prescribed antidepressants, while 478 were not. This stratification allowed the researchers to compare surgical outcomes across three groups: patients without depression, patients with treated depression, and patients with untreated depression. This granular approach provides richer insight into how pharmacologic management of depression interfaces with surgical resilience and recovery.
Outcomes were rigorously defined in terms of an “ideal” postoperative course, which included the absence of surgical complications, avoidance of protracted hospital stays, no readmissions within 90 days, and survival beyond 90 days post-surgery. This composite endpoint highlights a clinically meaningful benchmark emphasizing quality recovery rather than isolated metrics. The study’s findings demonstrate that patients suffering from depression, regardless of treatment status, generally experience poorer recovery trajectories compared to those without depression.
However, the data revealed a significant mitigating effect of antidepressant therapy. Patients receiving pharmacological treatment for depression exhibited notably better outcomes compared to their untreated counterparts. These improvements extended beyond clinical markers to include shorter hospital stays, reduced readmission rates, and lower postoperative mortality rates. Such findings underscore the potential of antidepressants not only to alleviate psychiatric symptoms but to foster physiological resilience during the vulnerable perioperative period.
The economic implications were equally striking. Patients without depression had the lowest average cost of surgical care, calculated at approximately $17,551. Those with treated depression experienced a modest increase of 7.3% in healthcare expenditures, while costs soared by over 10% for patients with untreated depression. This correlation between mental health treatment and reduced financial burden provides a compelling argument for integrating psychiatric care into surgical protocols, possibly alleviating strain on healthcare systems burdened by costly postoperative complications.
Exploring the potential mechanisms behind these observations, the investigators point to the well-documented tendency of depression to reduce adherence to medical regimens, including both pharmacological treatments and recommended lifestyle interventions. Depression’s detrimental impact on motivation and executive functioning may hinder patients’ ability to participate actively in their care plans, jeopardizing recovery. By treating depression, healthcare providers can potentially enhance patient engagement, promote self-care, and improve compliance with postoperative guidelines, thereby leading to better outcomes.
Furthermore, the impetus for this research emerged during the COVID-19 pandemic, which dramatically heightened awareness of mental health issues worldwide. The pandemic underscored the complex interplay between psychosocial stressors and physical illness, prompting researchers at The Ohio State University to investigate how mental health intersected with surgical outcomes. Recognizing health-related social needs, including food insecurity, job instability, and domestic violence, the team sought a broader understanding of the factors influencing recovery beyond purely biomedical variables.
While the study highlights the need for systematic depression screening in surgical candidates, it also acknowledges certain limitations. The use of antidepressant prescriptions as a proxy for depression treatment does not capture non-pharmacological interventions, such as psychotherapy or psychiatric care, which may also impact outcomes. In addition, the retrospective design limits causative conclusions, and future prospective studies are needed to validate these findings and explore the nuanced effects of different types and durations of depression management.
Importantly, the senior author, Dr. Timothy M. Pawlik, emphasizes that integrating mental health evaluation into preoperative planning could empower surgeons and healthcare teams to craft holistic, individualized treatments. Addressing psychological comorbidities proactively may help anticipate complications, reduce morbidity and mortality, and optimize patient-centered care. Patients are encouraged to acknowledge and communicate their mental health needs as part of their surgical journey to achieve the best possible recovery.
This study represents a significant step toward bridging the gap between mental and physical health in surgical oncology, demonstrating that effective psychiatric treatment is not just beneficial for mood symptoms but is a critical component of improving survival and recovery after complex cancer surgeries. The findings resonate with a growing movement to view patient care through a biopsychosocial lens, advocating for interdisciplinary approaches that address the whole patient, rather than isolated disease processes.
In conclusion, depression substantially hampers recovery after major abdominal cancer surgeries in older adults. Nonetheless, antidepressant treatment appears to mitigate these effects, resulting in better surgical outcomes, shorter hospital stays, decreased readmissions, lower mortality, and reduced healthcare costs. This data underscores the imperative to prioritize mental health screening and intervention as integral aspects of perioperative care. As the healthcare community moves toward more comprehensive patient care models, such evidence could catalyze protocol changes that improve quality of life and survival rates for vulnerable populations.
Subject of Research: Impact of depression and antidepressant treatment on surgical outcomes in patients with colorectal, hepatobiliary, and pancreatic cancers.
Article Title: The Impact of Antidepressants on Surgical Outcomes in Patients with Abdominal Cancer and Comorbid Depression
News Publication Date: October 3, 2025
Web References:
– American College of Surgeons Clinical Congress 2025: https://www.facs.org/for-medical-professionals/conferences-and-meetings/clinical-congress-2025/
– Depression and sleep disruption: https://www.tandfonline.com/doi/full/10.31887/DCNS.2008.10.3/dnutt
– Depression and cancer risk: https://www.mdpi.com/2076-3425/13/2/302
References: Katayama E, et al. The Impact of Antidepressants on Surgical Outcomes in Patients with Abdominal Cancer and Comorbid Depression, Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2025.
Keywords: Depression, Surgery, Antidepressants, Cancer, Colorectal Cancer, Hepatobiliary Cancer, Pancreatic Cancer, Surgical Outcomes, Postoperative Recovery, Healthcare Costs, Mental Health, Perioperative Care
Tags: American College of Surgeons Clinical Congress 2025antidepressants and postoperative outcomescancer patient mental health researchchronic diseases and depressioncolorectal cancer surgery and depressiondepression and surgical outcomeshealthcare costs and mental health treatmenthepatobiliary surgery outcomes and mental healthimpact of mental health on cancer recoveryolder adults and cancer surgerypancreatic cancer surgery recoverypsychological factors in surgical recovery
