Prevalence of posttraumatic stress disorder (PTSD) in patients with an incisional hernia

Am J Surg. 2019 Nov;218(5):934-939. doi: 10.1016/j.amjsurg.2019.03.002. Epub 2019 Mar 7.


Background: We investigate the prevalence of PTSD in patients with an incisional hernia presenting for evaluation at our institution.

Methods: Study patients were screened for PTSD using the PCL-5 checklist for DSM-5. Patient-reported quality of life and pain scores were assessed using validated tools (HerQLes and PROMIS Pain Intensity 3a survey).

Results: The prevalence of PTSD in 131 patients was 32.1% [95% CI 24%-40%]. Patients screening positive (PTSD+) reported lower quality of life scores on HerQles (17.3 ± 14.3 vs. 47.7 ± 29.6, P < 0.001), and higher pain scores on the PROMIS scale (54.2 ± 9.1 vs. 44.2 ± 10, p < 0.001). PTSD + patients also reported significantly higher numbers of previous hernia repairs and abdominal operations, as well as a higher rate of a history of an open abdomen.

Conclusion: Our study found a significant prevalence of positive screening for PTSD in patients seeking consultation regarding an incisional hernia. We have begun routine preoperative evaluations by a behavioral medicine specialist to address some of these complex issues in high-risk patients. Other high volume hernia programs caring for this challenging patient population should consider such assessments.

Keywords: Incisional hernia; Mental illness; PTSD; Posttraumatic stress disorder; Quality of life.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Herniorrhaphy / psychology*
  • Herniorrhaphy / statistics & numerical data
  • Humans
  • Incisional Hernia / epidemiology*
  • Incisional Hernia / psychology
  • Incisional Hernia / surgery
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Prevalence
  • Quality of Life
  • Risk Factors
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / psychology