Anxiety and depression in bariatric surgery patients: A prospective, follow-up study using structured clinical interviews

• Published in: Journal of affective disorders 2011-09, Vol.133 (1), p.61-68
• Main Authors: de Zwaan, Martina, Enderle, Janna, Wagner, Sebastian, Mühlhans, Barbara, Ditzen, Beate, Gefeller, Olaf, Mitchell, James E, Müller, Astrid
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Anxiety; Anxiety Disorders - complications; Anxiety Disorders - epidemiology; Anxiety-Depression; Bariatric surgery; Bariatric Surgery - psychology; Biological and medical sciences; Comorbidity; Depression; Depressive Disorder - complications; Depressive Disorder - epidemiology; Depressive personality disorders; Female; Follow-Up Studies; Gastric restriction surgery; Humans; Longitudinal Studies; Male; Medical sciences; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental Disorders - surgery; Middle Aged; Mood disorders; Obesity, Morbid - complications; Obesity, Morbid - psychology; Obesity, Morbid - surgery; Postoperative anxiety; Postoperative Period; Preoperative; Prevalence; Prognosis; Prospective Studies; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy; Weight Loss
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2011.03.025

Abstract 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.