Prevalence of depression and anxiety disorders among bariatric surgery patients

Authors

Keywords:

Bariatric surgery, Obesity surgery, Preoperative assessment, Bariatric anxiety, Bariatric depression

Abstract

Aim: Obesity carries with itself an increased risk of psychological distress, depression and anxiety. Several studies have proven that the best modality of treatment for morbid obesity is bariatric surgery. However, the outcome of bariatric surgery on psychological health varies between individuals. Comprehensive perioperative mental health evaluation for patients seeking bariatric surgery is important, as psychiatric comorbidities could result in poor outcomes, and based on our knowledge, studies on psychiatric outcomes post bariatric surgery are limited in Saudi Arabia. This study is aimed at assessing the impact of bariatric surgery on developing depression and anxiety symptoms.

Methods: Data for this cross-sectional study were collected from patients via an electronic self-administered questionnaire of both genders who underwent bariatric surgery during the period between July 2013 and July 2017 at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia.

Results: The total number of the participants was 214, wherein 66 (30.8%) were males and 150 (69.2%) were females. Participants who underwent bariatric surgery ranged between 17 and 64 years of age with a median age of 36.69 years. With regards to preoperative assessment, we found that 95.8% of our sample did not visit a psychiatry clinic. The postoperative percentage of depression and anxiety among patients was 67 (31.3%) and 40 (18.7%), respectively. Using multivariate regression analysis, patients’ income was found to be significantly associated with anxiety, those who had higher income had less odds of being anxious compared to the group with low income (<3000 riyals) and this was statistically significant. 

Conclusion: Compared to general population, the post bariatric surgery prevalence of anxiety and depression is high. We recommend pre- and postoperative psychiatric assessment for all bariatric surgery patients in centers where this has not yet been implemented in the pre- and postoperative protocols.

Downloads

Download data is not yet available.

References

Toghaw P, Matone A, Lenbury Y, De Gaetano A. Bariatric surgery and T2DM improvement mechanisms: a mathematical model. Theor Biol Med Model. 2012;9:16.

Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol. 2006;26(5):968-76.

Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579-91.

Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444(7121):881-7.

Musella M, Milone M, Bellini M, Fernandez ME, Fernandez LM, Leongito M, et al. The potential role of intragastric balloon in the treatment of obese-related infertility: personal experience. Obes Surg. 2011;21(4):426-30.

Musella M, Milone M, Bellini M, Sosa Fernandez LM, Leongito M, Milone F. Effect of bariatric surgery on obesity-related infertility. Surg Obes Relat Dis. 2012;8(4):445-9.

Kubik JF, Gill RS, Laffin M, Karmali S. The impact of bariatric surgery on psychological health. J Obes. 2013;2013:837989.

Crisp AH, McGuiness B. Jolly fat: relation between obesity and psychoneurosis in general population. Br Med J. 1976;1(6000):7-9.

Noria SF, Grantcharov T. Biological effects of bariatric surgery on obesity-related comorbidities. Can J Surg. 2013;56(1):47-57.

Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP, Pilkonis PA, Ringham RM, et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry. 2007;164(2):328-34; quiz 74.

Powers PS, Perez A, Boyd F, Rosemurgy A. Eating pathology before and after bariatric surgery: a prospective study. Int J Eat Disord. 1999;25(3):293-300.

Wadden TA, Sarwer DB, Womble LG, Foster GD, McGuckin BG, Schimmel A. Psychosocial aspects of obesity and obesity surgery. Surg Clin North Am. 2001;81(5):1001-24.

Lier HO, Biringer E, Stubhaug B, Tangen T. Prevalence of psychiatric disorders before and 1 year after bariatric surgery: the role of shame in maintenance of psychiatric disorders in patients undergoing bariatric surgery. Nord J Psychiatry. 2013;67(2):89-96.

de Zwaan M, Enderle J, Wagner S, Muhlhans B, Ditzen B, Gefeller O, et al. Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. J Affect Disord. 2011;133(1-2):61-8.

Frigg A, Peterli R, Peters T, Ackermann C, Tondelli P. Reduction in co-morbidities 4 years after laparoscopic adjustable gastric banding. Obes Surg. 2004;14(2):216-23.

Mitchell JE, King WC, Chen JY, Devlin MJ, Flum D, Garcia L, et al. Course of depressive symptoms and treatment in the longitudinal assessment of bariatric surgery (LABS-2) study. Obesity (Silver Spring). 2014;22(8):1799-806.

Ivezaj V, Grilo CM. When mood worsens after gastric bypass surgery: characterization of bariatric patients with increases in depressive symptoms following surgery. Obes Surg. 2015;25(3):423-9.

Duarte-Guerra LS, Coelho BM, Santo MA, Wang YP. Psychiatric disorders among obese patients seeking bariatric surgery: results of structured clinical interviews. Obes Surg. 2015;25(5):830-7.

Wadden TA, Sarwer DB. Behavioral assessment of candidates for bariatric surgery: a patient-oriented approach. Obesity (Silver Spring). 2006;14 Suppl 2:53S-62S.

Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7.

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13.

Zhong QY, Gelaye B, Zaslavsky AM, Fann JR, Rondon MB, Sanchez SE, et al. Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women. PloS one. 2015;10(4):e0125096.

Locke AB, Kirst N, Shultz CG. Diagnosis and management of generalized anxiety disorder and panic disorder in adults. Am Fam Physician. 2015;91(9):617-24.

Manea L, Gilbody S, McMillan D. Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis. Canadian Medical Association journal. 2012;184(3):E191-6.

Alley JB, Fenton SJ, Harnisch MC, Tapper DN, Pfluke JM, Peterson RM. Quality of life after sleeve gastrectomy and adjustable gastric banding. Surg Obes Relat Dis. 2012;8(1):31-40.

Al-Qadhi W, Ur Rahman S, Ferwana MS, Abdulmajeed IA. Adult depression screening in Saudi primary care: prevalence, instrument and cost. BMC psychiatry. 2014;14:190.

Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119-38.

Matini D, Ghanbari Jolfaei A, Pazouki A, Pishgahroudsari M, Ehtesham M. The comparison of severity and prevalence of major depressive disorder, general anxiety disorder and eating disorders before and after bariatric surgery. Med J Islam Repub Iran. 2014;28:109.

Remes O, Brayne C, van der Linde R, Lafortune L. A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain Behav. 2016;6(7):e00497.

Tae B, Pelaggi ER, Moreira JG, Waisberg J, de Matos LL, D'Elia G. Impact of bariatric surgery on depression and anxiety symptons, bulimic behaviors and quality of life. Rev Col Bras Cir. 2014;41(3):155-60.

Blanco C, Rubio J, Wall M, Wang S, Jiu CJ, Kendler KS. Risk factors for anxiety disorders: common and specific effects in a national sample. Depress Anxiety. 2014;31(9):756-64.

Brandão I, Fernandes AL, Osório E, Calhau MdC, Coelho R. A psychiatric perspective view of bariatric surgery patients. Arch Clin Psychiatry (São Paulo). 2015;42:122-8.

Downloads

Published

2019-08-01

Issue

Section

Research Article

How to Cite

1.
Sait S, Trabulsi N, Zagzoog M, Mortada H, Altowaireb A, Hemdi A, Nassif M, Altaf A. Prevalence of depression and anxiety disorders among bariatric surgery patients. J Surg Med [Internet]. 2019 Aug. 1 [cited 2024 Apr. 20];3(8):574-8. Available from: https://jsurgmed.com/article/view/604856