Depressive symptoms in children after tonsillectomy

Objective: Several cases of severe depression after tonsillectomy have been described in children, indicating psychological trauma after surgery and hospitalization. The actual prevalence of depressive symptoms after tonsillectomy is unknown and possibly underestimated. This study aims to quantify this problem by employing current diagnostic methods. Methods: This is a prospective study of 159 children who underwent tonsillectomy,in a major Pediatric University Hospital. All patients stayed in the hospital overnight. Parents were sent questionnaires based on diagnostic criteria for depression (ICD-10) 3 weeks postoperatively. Whenever the criteria for a depressive episode were met, a telephone interview with the parents followed 3 months after the operation. Results: Some 89 questionnaires were returned (56%), revealing that 15 patients (17%), 4-16 years old, developed depressive symptomatology compared with a 4% prevalence of depression in the general child population and 10-20% in the pediatric hospital populations. No children had persisting symptoms 3 months later. Conclusions: These results suggest that post-tonsillectomy morbidity can occasionally manifest with depressive symptoms, usually resolving spontaneously. A high index of suspicion is required by the otolaryngologist, nurses and primary care physician for early diagnosis and referral of persisting cases to a specialist. Emphasis is given to a structured preoperative psychological preparation of pediatric patients. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.