In a study presented at the ANAESTHESIOLOGY 2024 annual meeting, characterises claim that a new computerised mental health screening tool, KCAT, may help clinicians spot anxiety and sadness in children scheduled for surgery more quickly. While the study demonstrates that the technology is feasible, concerns regarding its long-term consequences persist.

The tiny, single-center study found that more than half of the children tested had anxiety, and more than one-third had signs of depression before surgery. This research underscores a significant concern regarding untreated mental health issues in pediatric patients, as it may negatively impact their surgical experience.

The study administered KCAT, a computerized adaptive mental health screening instrument, to 65 children aged 7–18 who were scheduled for elective surgery. The average assessment time was slightly more than two minutes, making it suitable for preoperative use.

Elizabeth Pealy, M.D., the study's principal author and assistant professor of anesthesia and critical care at the University of Chicago, emphasised the prevalence of these diseases in paediatric surgery populations. "The use of the KCAT tool in paediatric patients in preoperative settings is very feasible, and the results of our pilot study show a substantial prevalence of these mental health conditions in this surgical population," according to her.

The researchers discovered that 57% of the children tested positive for anxiety, with 34% showing signs of despair. The growing prevalence of anxiety and depression in children creates specific issues in the surgical context, necessitating the development of such a tool. "Many kids are anxious before having surgery, and the stress of undergoing the actual procedure can accentuate it," Pealy pointed out.

Preoperative nervousness is prevalent in children and can impair their cooperation during anaesthetic induction. Longer recovery duration, increased postoperative pain, and even higher rates of delirium are associated with it. However, recognizing this anxiety is challenging without suitable screening methods, especially because young people may not always express their emotions clearly.

Dr. Sarah Nizamuddin, the study's co-author, emphasised the necessity of timely mental health screenings. "This is the first study to examine the use of this tool on children in this setting," she told me. "The ability to rapidly assess and capture anxiety and depression levels can allow providers to offer a variety of anxiety-reducing options prior to and after surgery to the patients who would benefit the most."

Anxiety and despair among youngsters in the United States have increased dramatically in recent years, alarming healthcare specialists. The dilemma for paediatric anaesthesiologists is discerning whether a youngster has undiagnosed mental health issues or is merely anxious about surgery.

The KCAT tool's value stems from its capacity to quickly evaluate children without requiring a skilled clinician interviewer. The tablet-based technology provides real-time assessments, allowing healthcare providers to be proactive in treating the child's mental health during the perioperative period.

Despite these encouraging results, there are still questions about how to effectively change patient care using the data from KCAT examinations. Nizamuddin advocated for further investigation into the potential advantages of this type of screening. "Further studies should aim to determine how to better cater to the needs of paediatric patients to improve their experience during surgery," Nizamuddin stated.

In conclusion, while the KCAT tool offers a potentially beneficial way to detect mental health difficulties in children prior to surgery, its overall effectiveness and larger implications for pediatric treatment require additional investigation. For the time being, it represents a hopeful start toward addressing the mental health issues that children experience when they undergo surgery.