A study published in the British Journal of Surgery claims that anxiety and depression make recovery from surgery harder and take longer. The study included 177,000 patients who were experiencing hip and knee replacement, or hernia and varicose vein surgeries over a two year period.
Anxiety, Depression Delay Healing, Study Shows

According to writer David Di Salvo, the researchers were careful to account for factors that typically influence surgery outcomes, including other health conditions, and the complexity of the procedure being performed.
The results of the study reveal that patients with moderate anxiety or depression were more likely than others to have wound complications and to be readmitted to the hospital. On average they had longer hospital stays. Those with more severe anxiety and depression tended to have worse complications.
It seemed to the researchers that anxiety and depression took a toll on patient’s physical health from the inside out. They were physically less able to heal than those without depression or anxiety.
Di Salvo quoted Philip Britteon, BSc, MSc, post-doctoral candidate at The University of Manchester, lead study author, as saying, “The study emphasizes the importance of the psychological state before surgery, and the fact that psychological disorders are often overlooked. Preoperative assessment should address psychological as well as physical health, given the significant impact of anxiety and depression on wound-related complications and readmissions.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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