Prevalence of positive depression screening among preoperative patients in Singapore

This is the authors' abstract. We don't add key points for this paper.

Depression is under-recognised in surgical populations despite its association with adverse postoperative outcomes. Data from Southeast Asian perioperative settings remain limited. We aimed to estimate the prevalence of clinically significant depression in a preoperative population in Singapore. We conducted a cross-sectional study at Singapore General Hospital in October 2025. Adults aged ≥ 21 years presenting for elective surgery completed a two-stage screening protocol using the Patient Health Questionnaire-2 (PHQ-2), followed by the PHQ-9 for those scoring ≥ 3. The primary outcome was prevalence of clinically significant depression (PHQ-9 ≥ 10). Analyses were descriptive, with comparisons by age, sex, and comorbidities. 255 patients were included (median age 58 years [IQR 42–69]; 136 [53.3%] female). Eighteen patients (7.1%) screened positive on PHQ-2 and completed PHQ-9. Clinically significant depressive symptoms were identified in 12 patients (4.7% [95% CI 2.7–8.0]). Prevalence was highest in patients aged 21–40 years (8.8%) and decreased with age, with no cases observed in those aged ≥ 71 years. Depression was more frequent in females than males, although differences were not statistically significant. Approximately one in 20 preoperative patients had clinically significant depressive symptoms, most without prior diagnosis. Routine mental health preoperative screening may have clinical value and represents an opportunity to identify at-risk individuals, particularly younger patients and females. Further studies should evaluate whether targeted perioperative interventions improve outcomes.