RESUMEN
PURPOSE OF REVIEW: Individuals with morbid obesity benefit from bariatric surgery with respect to weight loss and decreases in obesity-related somatic disorders. This paper focuses on psychosocial outcomes and provides a narrative review of recent meta-analyses and controlled studies concerning postoperative depression and suicide. RECENT FINDINGS: Considerable evidence shows short- and medium-term improvement in depressive symptoms after surgery. However, a subgroup of patients exhibits erosion of these improvements or new onset of depression in the long run. Some studies have found an increased risk for suicide among postoperative patients. Prospective longitudinal examinations of factors contributing to the increased risk for postoperative depression and suicide and the interaction between these factors are warranted. The inclusion of mental health professionals in bariatric teams would help to monitor patients for negative psychosocial outcomes and to identify those patients who are vulnerable to depression, suicide, and any other forms of deliberated self-harm following surgery.
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Cirugía Bariátrica/psicología , Cirugía Bariátrica/estadística & datos numéricos , Depresión/epidemiología , Obesidad Mórbida/psicología , Obesidad Mórbida/cirugía , Suicidio/estadística & datos numéricos , Humanos , Obesidad Mórbida/epidemiología , Estudios ProspectivosRESUMEN
INTRODUCTION: Given the lack of research on the relationship of post-surgery dumping syndrome and eating disturbances, the purpose of the present longitudinal study was to investigate whether dumping after obesity surgery is associated with pre-/postoperative eating disorder symptoms or addiction-like eating beyond the type of surgery, gender, health-realted quality of life (HRQoL) and anxiety/depressive symptoms. METHODS: The study included 220 patients (76% women) before (t0) and 6 months after (t1) obesity surgery (sleeve gastrectomy [n = 152], Roux-en-Y gastric bypass [n = 53], omega loop gastric bypass [n = 15]). The Sigstad Dumping Score was used to assess post-surgery dumping syndrome. Participants further answered the Eating Disorder Examination Questionnaire (EDE-Q), Yale Food Addiction Scale 2.0 (YFAS 2.0), Short-Form Health Survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) at t0 and t1. RESULTS: The point prevalence of symptoms suggestive of post-surgery dumping syndrome was 33%. Regression analyses indicate an association of dumping with surgical procedure (bypass), female gender, reduced HRQoL, more anxiety/depressive symptoms, and potentially with binge eating but not with eating disorder symptoms in general or with addiction-like eating. CONCLUSION: The current study failed to show a close relationship between the presence of self-reported dumping syndrome and eating disorder symptoms or addiction-like eating following obesity surgery. Further studies with longer follow-up periods should make use of clinical interviews to assess psychosocial variables and of objective measures to diagnose dumping in addition to standardized self-ratings.
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Derivación Gástrica , Obesidad Mórbida , Humanos , Femenino , Masculino , Síndrome de Vaciamiento Rápido/etiología , Síndrome de Vaciamiento Rápido/epidemiología , Síndrome de Vaciamiento Rápido/psicología , Obesidad Mórbida/epidemiología , Depresión/epidemiología , Estudios Longitudinales , Calidad de Vida , Derivación Gástrica/efectos adversos , Derivación Gástrica/métodos , Ansiedad/etiologíaRESUMEN
PURPOSE: Previous research on obesity surgery (OS) showed that patients do not only experience weight loss but also improvements in certain mental health outcomes (e.g., depression) after OS. However, self-harm behaviors might increase after OS. Regarding self-harm, the literature is mostly limited to studies using data from hospital or emergency room charts. This longitudinal study examined self-reported self-harm behaviors and potential psychopathological correlates before and after OS. MATERIALS AND METHODS: Pre-surgery patients (N = 220) filled out a set of questionnaires before and approximately six months after OS. Self-harm behaviors were captured with the Self-Harm Inventory. The assessments further included standardized instruments to measure symptoms of depression, anxiety, eating disorders, alcohol use, and suicidal ideations. RESULTS: Any self-harm was reported by 24.6% before and by 25.0% after OS. No differences in the number of self-harm behaviors or prevalence of any self-harm before and after OS were found. Overall, 11.4% experienced self-harm behaviors at both times. A subset showed self-harm behaviors only before (13.2%) OS and another subset only after OS (13.6%). These two groups were about the same size. Self-harm behaviors showed strong associations with psychopathology after OS, especially with depression and suicidal ideation. CONCLUSION: No increase in self-harm behaviors after OS emerged. Still, a subgroup showed self-harm behaviors after OS closely linked to further psychopathology. This mirrors the need to implement screening for self-harm before and after OS into OS care. Further studies with longer follow up periods are needed to extend these findings.