Improvement in mood symptoms after post‐bariatric surgery among people with obesity: A systematic review and meta‐analysis (original) (raw)
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Obesity, 2014
Objective: To examine changes in depressive symptoms and treatment in the first 3 years following bariatric surgery. Methods: The longitudinal assessment of bariatric surgery-2 (LABS-2) is an observational cohort study of adults (n 5 2,458) who underwent a bariatric surgical procedure at 1 of 10 US hospitals between 2006 and 2009. This study includes 2,148 participants who completed the Beck depression inventory (BDI) at baseline and one follow-up visit in years 1-3. Results: At baseline, 40.4% self-reported treatment for depression. At least mild depressive symptoms (BDI score 10) were reported by 28.3%; moderate (BDI score 19-29) and severe (BDI score 30) symptoms were uncommon (4.2 and 0.5%, respectively). Mild-to-severe depressive symptoms independently increased the odds (OR 5 1.75; P 5 0.03) of a major adverse event within 30 days of surgery. Compared with baseline, symptom severity was significantly lower at all follow-up time points (e.g., mild-to-severe symptomatology was 8.9%, 6 months; 8.4%, 1year; 12.2%, 2 years; 15.6%, 3 years; ps < 0.001), but increased between 1 and 3 years postoperatively (P < 0.01). Change in depressive symptoms was significantly related to change in body mass index (r 5 0.42; P < 0001). Conclusion: Bariatric surgery has a positive impact on depressive features. However, data suggest some deterioration in improvement after the first postoperative year. LABS-2, #NCT00465829,
Clinical versus patient-reported measures of depression in bariatric surgery
Surgical endoscopy, 2018
Bariatric surgery patients with mental illness may experience worse surgical outcomes compared to those without. Depression is the most prevalent mental health diagnosis amongst Americans with obesity. Accurate diagnosis and treatment is of paramount importance to mitigate perioperative risk. Unfortunately, there is no standard method to screen patients for depression prior to surgery. Our goal was to understand the relationship between traditional clinical screening tools and a novel patient-reported depression screening survey, Patient Health Questionnaire 8 (PHQ-8), in the setting of the bariatric surgery preoperative assessment. The study included all adult bariatric surgery patients from January 2014 through June 2016. Patients who were not assessed using both the PHQ-8 and a traditional clinical depression screening were excluded from the study. There were a total of 4486 patients who met the eligibility criteria and were included in analysis. We used comparative statistics to...
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.
Relationship between depression, weight, and patient satisfaction 2 years after bariatric surgery
Surgery for Obesity and Related Diseases, 2021
Background: Findings regarding longer term symptoms of depression and the impact of depression on outcomes such as weight loss and patient satisfaction, are mixed or lacking. Objectives: This study sought to understand the relationship between depression, weight loss, and patient satisfaction in the two years after bariatric surgery. Setting: This study used data from a multi-institutional, statewide quality improvement collaborative of 45 different bariatric surgery sites. Methods: Participants included patients (N 5 1991) who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2015-2018. Participants self-reported symptoms of depression (Patient Health Questionnaire-8 [PHQ-8]), satisfaction with surgery, and weight presurgery and 1 year and 2 years postsurgery. Results: Compared to presurgery, fewer patients' PHQ-8 scores indicated clinically significant depression (PHQ-810) at 1 year (P , .001; 14.3% versus 5.1%) and 2 years postsurgery (P , .0001; 8.7%). There was a significant increase in the prevalence of clinical depression from the first to second year postsurgery (P , .0001; 5.1% versus 8.7%). Higher PHQ-8 at baseline was related to less weight loss (%Total Weight Loss [%TWL] and %Excess Weight Loss [%EWL]) at 1 year postsurgery (P , .001), with a trend toward statistical significance at 2 years (P 5 .06). Postoperative depression was related to lower %TWL and %EWL, and less reduction in body mass index (BMI) at 1 year (P , .001) and 2 years (P , .0001). Baseline and postoperative depression were associated with lower patient satisfaction at both postoperative time points. Conclusions: This study suggests improvements in depression up to 2 years postbariatric surgery, although it appears that the prevalence of depression increases after the first year. Depression, both pre-and postbariatric surgery, may impact weight loss and patient satisfaction.
The effects of weight loss after bariatric surgery on health-related quality of life and depression
Nutrition & Diabetes, 2014
BACKGROUND: In severe obesity, impairments in health-related quality of life (HRQoL) and dysphoric mood are reported. This is a post-surgery analysis of the relationship between HRQoL and depressive symptoms, and weight change after four different types of bariatric procedures. METHODS: A total of 105 consented patients completed the Short-Form-36 Health Survey (SF-36), the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and the Beck Depression Inventory (BDI) before and 25 months after surgery. Analysis of variance or Kruskal-Wallis test evaluated changes. RESULTS: Patients with Roux-en Y gastric bypass (46 patients), decreased body mass indexes (BMIs; kg m-2) 47-31 kg m-2 (P o 0.0001); biliopancreatic diversion with duodenal switch (18 patients), decreased BMIs 57-30 kg m-2 (P o 0.0001); adjustable gastric banding (18 patients), decreased BMIs 45-38 kg m-2 (P o0.0001); and sleeve gastrectomies (23 patients), decreased BMIs 58 42 kg m-2 (P o 0.0001). The excess percentage BMI loss was 69, 89, 36 and 53 kg m-2 , respectively (P o 0.0001). Before surgery, the SF-36 differences were significant regarding bodily pain (P = 0.008) and social functioning (P = 0.01). After surgery, physical function (P = 0.03), general health (P = 0.05) and physical component (P = 0.03) were different. IWQOL-Lite recorded no differences until after surgery: physical function (P = 0.003), sexual life (P = 0.04) and public distress (P = 0.003). BDI scores were not different for the four groups at baseline. All improved with surgery, 10.6-4.4 (P = 0.0001). CONCLUSIONS: HRQoL and depressive symptoms significantly improvement after surgery. These improvements do not have a differential effect over the wide range of weight change.
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.
Journal of Obesity and Chronic Diseases
Background: Psychosocial factors, identified in pre-bariatric surgery evaluation, may affect surgical outcomes, as well as defer surgery, making it important to identify psychosocial predictors of surgery outcomes. Methods: Baseline depressive and social anxiety symptom scores were analyzed as predictors of post-surgical weight loss (WL) and quality of life (QOL) following Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB). Eighty-nine (82F, 7M) participants underwent surgery and completed depression, anxiety and QOL questionnaires 3-weeks pre-surgery and 1-year post-surgery. Results: Depressive scores and QOL scores improved post-surgery (P < 0.001), whereas social anxiety scores did not (P = 0.20). Baseline depressive (P = 0.90) and social anxiety (P = 0.20) scores did not predict % weight loss (WL) at 1 year, but higher baseline depressive (P = 0.04) and social anxiety (P = 0.005) scores predicted lower post-surgical QOL at 1 year. RYGB showed greater improvement in %WL (P < 0.001) than AGB, but no difference between the groups in QOL (P = 0.10). Improvement in QOL correlated with %WL (P < 0.001), whereas improvement in depressive scores did not correlate with %WL (P = 0.70) but did correlate with improvement in QOL (P = 0.01). Conclusions: Baseline depressive and social anxiety scores predicted QOL but not %WL. Depressive and QOL scores improved post-surgery, but social anxiety scores did not. The findings suggest that patients who present with depressive or social anxiety symptoms pre-surgery perhaps should not be deferred; however, more studies are needed to confirm this. Patients with pre-operative social anxiety symptoms may benefit from counseling.
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.
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 ...
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).