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World J Psychiatry. Oct 19, 2026; 16(10): 116326
Published online Oct 19, 2026. doi: 10.5498/wjp.116326
Integrating mind and physiology: Bridging psychophysiology and preoperative care in vascular surgery
Luca Galassi, Beatrice Faitelli, Martina Spanevello, Anna Pedrazzini, Matteo Lino Ravini, Marialetizia Latella
Luca Galassi, Postgraduate School of Vascular and Endovascular Surgery, University of Milan, Milan 20122, Lombardy, Italy
Beatrice Faitelli, Postgraduate School of Hospital Pharmacy, University of Milan, Milan 20122, Lombardy, Italy
Martina Spanevello, Postgraduate School of Cardiac Surgery, University of Milan, Milan 20122, Lombardy, Italy
Anna Pedrazzini, School of Medicine and Surgery, University of Milan, Milan 20122, Lombardy, Italy
Matteo Lino Ravini, Department of Vascular and Endovascular Unit, Istituto di Ricovero e Cura a Carattere Scientifico Galeazzi-Sant’Ambrogio, Milan 20157, Lombardy, Italy
Marialetizia Latella, Laboratory of Nutritional Sciences, Istituto di Ricovero e Cura a Carattere Scientifico Galeazzi-Sant’Ambrogio, Milan 20157, Lombardy, Italy
Author contributions: Galassi L, Faitelli B, and Spanevello M contributed to writing original draft preparation; Galassi L, Spanevello M, Pedrazzini A, and Ravini ML contributed to validation; Galassi L, Faitelli B, Spanevello M, Pedrazzini A, Ravini ML, and Latella M contributed to conceptualization and writing review and editing; and all authors have read and agreed to the published version of the manuscript.
AI contribution statement: The manuscript was not generated using artificial intelligence tools. However, standard digital tools embedded in word processing software may have been used for basic grammar and spelling checks during the revision process, as is common in academic writing. The scientific content, including the Abstract, Introduction, Materials and Methods, Results, Discussion, and Conclusion, was entirely conceived, written, and revised by the authors. No section of the manuscript was generated by AI.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Luca Galassi, MD, Lecturer, Researcher, Postgraduate School of Vascular and Endovascular Surgery, University of Milan, Festa del Perdono Street, Milan 20122, Lombardy, Italy.
luca.galassi@unimi.it
Received: November 10, 2025
Revised: November 26, 2025
Accepted: February 5, 2026
Published online: October 19, 2026
Processing time: 336 Days and 18.8 Hours
In this editorial, we comment on the article by Salem et al published in the recent issue of the World Journal of Psychiatry. Patients undergoing vascular surgery face a substantial psychological burden due to the chronic and severe nature of their conditions, often involving the threat of limb loss or life-threatening complications. Up to 40% experience significant preoperative anxiety, which has been increasingly linked to perioperative hemodynamic instability, anesthetic challenges, postoperative pain, wound complications, and delayed clinical progress. Anxiety-driven sympathetic activation elevates blood pressure, heart rate, and vascular resistance, while sustained stress responses impair endothelial function, immune regulation, and tissue repair. Personality traits, including neuroticism and conscientiousness, may further modulate stress reactivity, influencing postoperative outcomes. Although literature identified through PubMed, EMBASE, and Scopus underscores the importance of psychological factors, integration of psychological assessment into standard perioperative protocols in vascular surgery remains limited. This editorial reviewed current evidence connecting psychological vulnerability with perioperative physiology and outcomes, and proposes a structured, patient-centered framework for implementing psychological evaluation and targeted interventions within a holistic, multidisciplinary preoperative care model.
Core Tip: Despite the well-established impact of psychological stress during the preoperative period on vascular surgery outcomes, it remains largely overlooked in everyday clinical practice. Psychological conditions such as anxiety, emotional instability, and maladaptive coping adversely affect hemodynamics, impair wound healing, and prolong recovery, whereas emotional stability and conscientiousness enhance adherence, patient satisfaction, and resilience. Integrating systematic psychological assessment, brief interventions, and strategies such as mindfulness or cognitive-behavioral therapy into preoperative care may provide a practical, low-cost approach to improving perioperative outcomes. This article emphasizes a holistic “mind-vessel” perspective, highlighting the translational potential of combining physiological and psychological optimization in vascular surgery.
