The Role of Mental Health in Postoperative Complications: A Literature Review

Kayla Monet Alwahhamy, Department of Surgery, Meharry Medical College, University of Tennessee, Nashville, United States of AmericaFollow
Abbas Rasoul Alwahhamy, Department of Cybersecurity Engineering, College of Artificial Intelligence and Cybersecurity Engineering, University of Al-Muthanna, Samawah, Iraq

Article Type

Review

Abstract

Background: Currently, it is not standard practice to screen all surgical patients both pre- and postoperatively for either a prior history of mental health disorders (MHD) or active symptoms of MHD at the time of surgery. This is despite growing evidence that MHDs may impact wound healing and are recognized as a mortality risk factor in many patients. Aim: This review aims to evaluate existing literature examining mental health (MH) in surgical patients, assess whether there is a relationship between MHDs and postoperative complication rates, and determine whether outcomes differ based on the timing of MHD manifestation (pre- vs. postoperatively). Methods: A comprehensive literature search was conducted using institutional access (Meharry Medical College) to major databases, employing search terms related to MH, key MHD diagnoses, and surgical outcomes and complications. Studies were critically assessed using standardized quality (Qi) and utility (Ui) indices. Outcomes were analyzed based on correlations between MHD diagnosis, timing, and postoperative complications. Results: Of the 17 studies (nine retrospective, six prospective, one literature review, one systematic review), 15 were high quality, and five had large sample sizes (n > 1000). Ten studies found that MHDs increased postoperative complication rates. Four studies indicated that a prior history of MHD increased postoperative complications. Three studies found an increased risk of complications if MHD symptoms worsened after surgery, while three studies found a decreased risk (10 studies did not measure MHD postoperatively for comparison in their study design). Conclusions: There is an association between MHD and postoperative complication rates across multiple surgical disciplines. However, further studies are needed to evaluate whether any prior diagnosis of MHD versus active MH symptoms at the time of surgery has a greater impact on predicting postoperative outcomes. Additionally, more research is required to evaluate whether preoperative or post-op MHD symptoms have a stronger association with postoperative outcomes.

Keywords

Surgery, Surgical outcomes, Postoperative complications, Mental health, MHD

Recommended Citation

Alwahhamy, Kayla Monet and Alwahhamy, Abbas Rasoul (2026) "The Role of Mental Health in Postoperative Complications: A Literature Review," Iraqi National Journal of Medicine: Vol. 8 : Iss. 2 , Article 8.
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