The Effect of Preoperative Diagnosis of Depression and/or Anxiety on Patient Reported Outcomes Following Chest Wall Masculinization Surgery
Monica Morgenstern, MS1, Carolina Torres Perez-Iglesias, MD1, Sivana Barron, BA1, Emmeline Jia, MS1, Brianna L. Slatnick, MD2, Valeria Bustos, MD1, Christine Kang, MD1, Amy Maselli, MD1, Bernard Lee, MD, MBA, MPH, FACS1, Adam M. Tobias, MD1, Ryan P. Cauley, MD, MPH1.
1Beth Israel Deaconess Medical Center, Boston, MA, USA, 2Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
PURPOSE: Individuals with gender dysphoria have high prevalence of mental health disorders. It is unclear if depression and anxiety negatively affect patient-reported outcomes after chest wall masculinization surgery. In this study, we assess the impact of preoperative anxiety or depression on clinical and patient-reported outcomes (PRO) for patients undergoing chest masculinization surgery.
METHODS: All patients undergoing chest masculinization surgery within our institution were reviewed(8/2014-8/2019). Demographics and clinical variables were abstracted from the medical records. PRO were collected postoperatively using the Chest-Q and Scar-Q questionnaires. Groups were stratified by preoperative anxiety, preoperative depression, and history of mental health disorders. Univariate analysis was performed.
RESULTS: 124 patients had complete survey responses. 12% had anxiety, 5.6% depression, 20.1% depression and anxiety, and 62% had no mental health disorder prior to their procedure(Table1). Demographics and preoperative characteristics were similar between groups. The presence of preoperative mental health disorders was not associated with a significantly higher rate of postoperative anxiety and depression. Satisfaction with chest and nipples scores were similar among the four groups.
CONCLUSION: A preoperative mental health disorder diagnosis in patients undergoing chest wall masculinization surgery did not significantly affect postoperative PRO, including overall satisfaction with chest and nipples. After chest masculinization surgery, there was a similarly low incidence of post-operative depression and anxiety in all groups, even those with a preoperative diagnosis of a mental health disorder. 
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