Communication Barriers and Facilitators to Specialist Pediatric Palliative Care Involvement in Pediatric Oncology Settings Across Canada.

Depression, a prevalent and debilitating mood disorder, is associated with substantial individual suffering and societal costs. The condition is characterized by a persistent low mood, loss of interest or pleasure, and a range of physical and psychological symptoms that significantly impair daily functioning []. The global landscape of depressive symptoms from 2001 to 2020 reveals a point prevalence of 34%, with major depressive disorder (MDD) and dysthymia affecting 8% and 4% of the population, respectively []. Despite the availability of pharmacological and psychotherapeutic interventions, challenges in diagnosis and treatment persist, often due to the complexity of the disorder, stigma, and limited access to healthcare services []. In the clinical context, depression is particularly significant in the perioperative period, where it can exacerbate postoperative outcomes and complicate recovery []. Postoperative depression, in particular, is a critical concern, as it can lead to prolonged hospital stays and diminished quality of life. Postoperative depression is characterized by a spectrum of mood disturbances that can range from subclinical symptoms to MDD episodes, with potential long‐term implications for patient recovery and quality of life [, ]. The postoperative depression reveals a complex interplay of genetic, psychological, and environmental factors, contributing to its variable presentation and diagnosis. The pathophysiology underlying this condition is not yet fully elucidated but is thought to involve neurochemical imbalances, particularly in the monoamine neurotransmitter systems, as well as alterations in the hypothalamic–pituitary–adrenal (HPA) axis [, ]. Risk factors for developing postoperative depression are multifaceted and include preexisting mental health conditions, gender, age, surgical trauma, and the presence of chronic medical comorbidities [, ]. The clinical manifestations can be subtle, often overshadowed by the physical symptoms of surgery, leading to underdiagnosis and undertreatment. Furthermore, there is a growing recognition of the bidirectional relationship between depression and surgical outcomes, where depression can both result from and contribute to adverse postoperative events [, ]. This underscores the imperative for a comprehensive understanding of postoperative depression to inform the development of effective screening, prevention, and treatment strategies. Bibliometric analysis is a quantitative research method that involves the statistical analysis of written publications to extract and map the intellectual structures of a given field []. It employs various metrics, such as citation counts and cocitation frequencies, to identify trends, patterns, and works within academic disciplines, thereby providing insights into the evolution and impact of research over time []. A recent bibliometric analysis emphasizes the pivotal role of brain‐derived neurotrophic factor (BDNF) in the pathogenesis and therapeutic mechanisms of depression []. Furthermore, the work by Li et al. [] emphasizes the growing focus on Alzheimer′s and depression, highlighting themes of disease mechanisms, early detection, enhancing quality of life, and managing neuropsychiatric symptoms. In addition, recent bibliometric studies have revealed significant trends in postoperative pain management after cesarean sections, postoperative delirium, and the interplay between postoperative pain and sleep disorders, as evidenced by the growing body of literature and the emergence of new research foci [–]. However, to date, there has been a notable absence of bibliometric analysis specifically targeting postoperative depression.