Impact of bariatric surgery on depression, anxiety and stress symptoms among patients with morbid obesity: international multicentre study in Poland and Germany (original) (raw)
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REVIEW STUDY: THE RELATION BETWEEN BARIATRIC SURGERY WITH DEPRESSION AND ANXIETY
Obesity has been linked to a variety of psychological problems and has been demonstrated to have a detrimental effect on one's overall well-being in several research investigations. Research has found that the link between obesity and mental health varies by culture. Predictors of reduced family income are associated with poorer self-assessed beauty; gender; health policy; life satisfaction; and socioeconomic situations. More weight reduction and better comorbidity remission have been seen in trials comparing bariatric surgery with non-surgical therapy for obesity. Some studies have shown that bariatric surgery improves mental health and quality of life, as well as the financial condition of patients. A few experts, like Borgeraas et al., have studied the impact of bariatric surgery on health, including psychological elements. Variability in weight loss results after bariatric surgery might be rather high. The kind of bariatric surgery done, weight reduction, medical comorbidity, and social support are all important predictors of improved mental health in bariatric surgery patients. Mental health benefits from bariatric surgery may be influenced by variables other than weight reduction alone, such as pre-existing health conditions and the aftermath of surgery. Sleeve-gastrectomy and gastric bypass surgery resulted in higher improvements in mental health than laparoscopic adjustable gastric banding and vertical banding gastroplasty, research by Picot et al. found (2 years). Possibly due to the fact that these operations result in increased weight loss throughout this timeframe.
2011
Background: Candidates for bariatric surgery frequently have co-morbid psychiatric problems. Methods: This study investigated the course and the prognostic significance of preoperative and postoperative anxiety and depressive disorders in 107 extremely obese bariatric surgery patients in a prospective design with face-to-face interviews (SCID) conducted prior to the surgery and postoperatively after 6-12 months and 24-36 months. Results: The point prevalence of depressive disorders but not of anxiety disorders decreased significantly after surgery. Preoperative depressive disorders predicted depressive disorders 24-36 months but not 6-12 months after surgery, whereas preoperative anxiety significantly predicted postoperative anxiety disorders at both follow-up time points. Preoperative lifetime and current depressive disorders were unrelated to postoperative weight loss whereas preoperative lifetime, but not current anxiety disorders were of negative prognostic value for postoperative weight loss. Patients with both depressive and anxiety disorders at baseline (current and lifetime) lost significantly less weight after surgery. Postoperative anxiety disorder was not associated with the degree of weight loss at any follow-up time-point; however postoperative depressive disorder was negatively associated with weight loss at the 24-36 month follow-up assessment point. Limitations: Missing data, limited statistical power, self-reported height and weight are the limitations of this study. Conclusions: As opposed to anxiety disorders, the point prevalence of depressive disorders decreased significantly after bariatric surgery. However, the presence of depressive disorders after bariatric surgery significantly predicted attenuated post-surgical improvements and may signal a need for clinical attention.
Predictors of Anxiety and Depression Symptoms in Bariatric Surgery Candidates
Bariatric Surgical Practice and Patient Care, 2016
Background: The aim of this study is to analyze medical and psychosocial variables among gender and morbidly obese (Class III) and super obese (Class IV) groups to examine their associations with anxiety and depression symptoms and to determine predictive factors for anxiety and depression symptoms. Methods: This cross-sectional descriptive study was conducted with a sample of 546 obese patients. Medical, sociodemographic, anxiety, depression, and eating disorder information were obtained from all participants. Results: The study included 358 women (65.6%) with an average age of 42.71 (Standard deviation [SD] = 10.50) years, and 188 men (34.4%) whose average age was 41.80 (SD = 9.13) years. We found that eating disorder symptoms were positive and statistically significant predictors of anxiety and depression symptoms (p < 0.001). This finding was confirmed by multiple linear regression analysis (p < 0.001). Conclusion: Among Class III and IV obese patients, eating disorder symptoms were clearly associated with anxiety and depression levels. Therefore, interventions directed toward these symptoms would likely be beneficial.
Revista do Colégio Brasileiro de Cirurgiões, 2014
OBJECTIVE: To assess psychiatric symptoms, substance use, quality of life and eating behavior of patients undergoing bariatric surgery before and after the procedure. METHODS: We conducted a prospective longitudinal study of 32 women undergoing bariatric surgery. To obtain data, the patients answered specific, self-administered questionnaires. RESULTS: We observed a reduction in depressive and anxious symptoms and also in bulimic behavior, as well as an improved quality of life in the physical, psychological and environmental domains. There was also a decrease in use of antidepressants and appetite suppressants, but the surgery was not a cessation factor in smoking and / or alcoholism. CONCLUSION: a decrease in psychiatric symptoms was observed after bariatric surgery, as well as the reduction in the use of psychoactive substances. In addition, there was an improvement in quality of life after surgical treatment of obesity.
Advances in Psychiatry, 2014
Objective. Obesity has been linked to psychiatric disorders in several studies. Prevalence and severity of psychiatric disorders are high in patients undergoing bariatric surgery. Thus, psychiatric assessment of bariatric surgery candidates has become a standard procedure. However, socially desirable responding leads to biased results in self-reported questionnaires. Here, bariatric surgery candidates were screened with the Patient Health Questionnaire (PHQ-D) additionally to the psychiatric examination. Method. 355 bariatric surgery candidates filled in the PHQ-D before the psychiatric examination as a part of the surgery assessment procedure. PHQ-D results were compared to psychiatric diagnoses and body mass index (BMI). Results. Gender ratio, mean BMI, and age were comparable to earlier studies. Depressive and somatization symptoms did not correlate to BMI. However, females showed higher prevalence of psychiatric disorders with elevated syndrome severity in depressive and somatization disorders, as well as more frequent antidepressant intake. Eating disorders and addiction disorders were rarely reported. Conclusion. The findings suggest a socially desirable responding when filling in the PHQ-D before bariatric surgery. The use of the PHQ-D in this patient sample could be augmented by psychometric tests with internal correction and validation scales. Furthermore, psychiatric examination should be separated from the surgery evaluation process.
International Journal of Psychology and Psychological Therapy
AbstrAct Bariatric surgery has proven to be the most effective treatment for severe obesity. Weight loss and long-term maintenance depend on patient's ability to implement permanent lifestyle changes. Presurgical psychological evaluation and intervention are proposed for a better post surgical prognosis. The aim of present study was to make a psychosocial profile with the results of psychological evaluation performed to 129 bariatric surgery candidates and to determine associations between psychological variables with obesity level. Patients were evaluated with an oral interview, the MINI International Neuropsychiatric Interview, and the following self-reported instruments: Beck Depression Inventory, Anxiety Sensitivity Inventory, Stress Control Perception, Risk Factors related to Eating Behavior Disorders Scale, Quality of Life and Health Inventory. Study population was divided in groups according to obesity level, evaluation results were compared according to these groups. Res...
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity
Purpose We aimed at investigating the lifetime prevalence of mood, eating and panic disorders in a large sample of obese patients referred to bariatric surgery. We also explored the patterns of psychiatric comorbidity and their relationship with Body Mass Index (BMI). Methods The sample was composed of patients consecutively referred for pre-surgical evaluation to the Obesity Center of Pisa University Hospital between January 2004 and November 2016. Clinical charts were retrieved and examined to obtain sociodemographic information, anthropometric variables and lifetime psychiatric diagnoses according to DSM-IV criteria. Results A total of 871 patients were included in the study; 72% were females, and most patients had BMI ≥ 40 kg/m2 (81%). Overall, 55% of the patients were diagnosed with at least one lifetime psychiatric disorder. Binge eating disorder (27.6%), major depressive disorder (16%), bipolar disorder type 2 (15.5%), and panic disorder (16%) were the most common psychiatric...
DergiPark (Istanbul University), 2021
Psychiatric comorbidities are commonly encountered in obese patients admitted for bariatric surgery among which major depressive disorder and anxiety disorder are the most common types. Although most studies demonstrate a significant reduction in psychiatric complaints at postoperative follow-up, the relationship or mechanism of such effect is not definitive. We report the emergence of major depressive disorder and anxiety disorder in a 57-yearold female patient at sixth-month follow-up with no family history of psychiatric disorder or preoperative psychiatric disorder. Symptomatic control has been achieved with selective serotonin reuptake inhibitor therapy. Hereby, we recommend close psychiatric follow-up of bariatric surgery candidates at pre and postoperative periods.
Mental Health Conditions Among Patients Seeking and Undergoing Bariatric Surgery
JAMA, 2016
IMPORTANCE Bariatric surgery is associated with sustained weight loss and improved physical health status for severely obese individuals. Mental health conditions may be common among patients seeking bariatric surgery; however, the prevalence of these conditions and whether they are associated with postoperative outcomes remains unknown. OBJECTIVE To determine the prevalence of mental health conditions among bariatric surgery candidates and recipients, to evaluate the association between preoperative mental health conditions and health outcomes following bariatric surgery, and to evaluate the association between surgery and the clinical course of mental health conditions. DATA SOURCES We searched PubMed, MEDLINE on OVID, and PsycINFO for studies published between January 1988 and November 2015. Study quality was assessed using an adapted tool for risk of bias; quality of evidence was rated based on GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. FINDINGS We identified 68 publications meeting inclusion criteria: 59 reporting the prevalence of preoperative mental health conditions (65 363 patients) and 27 reporting associations between preoperative mental health conditions and postoperative outcomes (50 182 patients). Among patients seeking and undergoing bariatric surgery, the most common mental health conditions, based on random-effects estimates of prevalence, were depression (19% [95% CI, 14%-25%]) and binge eating disorder (17% [95% CI, 13%-21%]). There was conflicting evidence regarding the association between preoperative mental health conditions and postoperative weight loss. Neither depression nor binge eating disorder was consistently associated with differences in weight outcomes. Bariatric surgery was, however, consistently associated with postoperative decreases in the prevalence of depression (7 studies; 8%-74% decrease) and the severity of depressive symptoms (6 studies; 40%-70% decrease).
The Complex Association Between Bariatric Surgery and Depression: a National Nested-Control Study
Obesity Surgery, 2021
Background Although bariatric surgery has been shown to reduce weight loss and obesity-related conditions, an improvement in depression remains unclear. The aim of this study was to determine whether bariatric surgery is associated with a resolution of depression, and the prevention of its onset. Method Patients with a BMI ≥ 30 kg/m2 who had undergone bariatric surgery were identified from the Clinical Practice Research Datalink (CPRD), matched 5:1 to controls. Cox regression analysis was used to determine the risk of developing de novo depression. Kaplan-Meier analysis compared the proportion of patients with no further consultations related to depression between the two groups. Results In total, 3534 patients who underwent surgery, of which 2018 (57%) had pre-existing depression, were matched to 15,480 controls. Cox proportional hazard modelling demonstrated surgery was associated with a HR of 1.50 (95% CI 1.32–1.71, p < 0.005) for developing de novo depression. For those with ...