Dataset Information

Impact of bariatric surgery on depression, anxiety and stress symptoms among patients with morbid obesity: international multicentre study in Poland and Germany.

ABSTRACT:

Background

There is a need to investigate how adopting different strategies for treating obesity in different countries in the European Union affects the psychological well-being of patients.

Aims

The aim of this study was to perform a comparative evaluation of psychiatric symptoms (depression, anxiety and stress) in patients undergoing bariatric surgery versus patients receiving conservative treatment for morbid obesity in Poland and Germany.

Method

A multicentre international prospective cohort study with 155 patients who underwent bariatric surgery and 409 patients who received conservative weight reduction treatment. Evaluation of the psychiatric symptoms was carried out for each patient at baseline and after 12 months of active treatment using a standardised Depression Anxiety Stress Scale questionnaire (DASS-21) questionnaire.

Results

After 12 months of active treatment, the level of psychiatric symptoms (depression, anxiety and stress) significantly decreased in both groups of patients: surgically treated versus conservatively treated patients from Poland and also from Germany. The median change in level of psychiatric symptoms among patients from both countries was significantly higher among surgically treated patients compared with conservatively treated patients (Poland P < 0.0001; Germany P < 0.0001). Improvements in the patient's mental health as a consequence of treatment were dependent on the specific strategy for treating obesity adopted in the analysed countries, the percentage of total weight loss and on gender.

Conclusions

The use of bariatric surgery in both Poland and Germany compared with non-surgical treatment for obesity resulted in more measurable benefits in the form of a decrease in psychiatric symptoms (depression, anxiety and stress) and reduction in body weight.

SUBMITTER: Paczkowska A

PROVIDER: S-EPMC8811782 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

Impact of bariatric surgery on depression, anxiety and stress symptoms among patients with morbid obesity: international multicentre study in Poland and Germany.

Paczkowska Anna A Hoffmann Karolina K Raakow Jonas J Pross Matthias M Berghaus Rafael R Michalak Michał M Bryl Wiesław W Marzec Kinga K Kopciuch Dorota D Zaprutko Tomasz T Ratajczak Piotr P Nowakowska Elżbieta E Kus Krzysztof K

BJPsych open 20220125 1

<h4>Background</h4>There is a need to investigate how adopting different strategies for treating obesity in different countries in the European Union affects the psychological well-being of patients.<h4>Aims</h4>The aim of this study was to perform a comparative evaluation of psychiatric symptoms (depression, anxiety and stress) in patients undergoing bariatric surgery versus patients receiving conservative treatment for morbid obesity in Poland and Germany.<h4>Method</h4>A multicentre internati ...[more]

PMID: 35074027

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Project description:ObjectivesBariatric surgery is an effective treatment for severe obesity that leads to significant physical health improvements. Few studies have prospectively described the short-term impact of surgery on mental health using standardised case-finding measures for anxiety or depressive disorders. This study describes the prevalence and short-term course of these conditions following surgery.DesignProspective observational cohort study.Setting12 National Health Service centres in England.ParticipantsParticipants studied took part in the By-Band-Sleeve study, a multicentre randomised controlled trial evaluating the surgical management of severe obesity. We included participants who had undergone surgery (gastric bypass, gastric band or sleeve gastrectomy) within 6 months of randomisation.Primary and secondary outcome measuresAnxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) at baseline and 12 months post-randomisation. Sociodemographic variables collected at prerandomisation included body mass index, age, sex, ethnicity, marital status, tobacco use, employment status and income band.ResultsIn our sample of 758 participants, 94.5% (n 716) and 93.9% (n 712) had completed baseline anxiety (HADS-A) and depression (HADS-D) subscales. At pre-randomisation 46.1% (n 330/716, 95% CI 42.4% to 49.7%) met clinical case criteria for anxiety and 48.2% (n 343/712, 95% CI 44.5% to 51.8%) for depression. Among participants returning completed 12 months post-randomisation questionnaires (HADS-A n 503/716, HADS-D n 498/712), there was a significant reduction in the proportion of clinical cases with anxiety (-9.5%, 95% CI -14.3% to -4.8% p<0.001) and depression (-22.3%, 95% CI -27.0% to -17.6% p<0.001).ConclusionsAlmost half of people undergoing bariatric surgery had underlying anxiety or depressive symptoms. In the short term, these symptoms appear to substantially improve. Future work must identify whether these effects are sustained beyond the first post-randomisation year.Trial registration numberNCT02841527 and ISRCTN00786323.

Project description:IntroductionThere is still paucity of knowledge about which factors can mediate the link between obesity and mental health problems. This study aimed to investigate psychological mediators of the association between different weight profiles (healthy, overweight, and obesity) and symptoms of depression, anxiety, and stress.MethodsA sample of 407 adults (≥18 years old) with different weight profiles recruited from general population was assessed for symptoms of depression, anxiety, and stress, and dimensions of emotion regulation and body investment/body image. Robust regression and robust mediation analyses were employed to investigate predictors and mediators of mental health outcomes in relation to different weight profiles.ResultsBody investment difficulties in relation to body image and body care, and emotion regulation difficulties related to a tendency towards negative secondary responses to negative emotions, and/or denial of distress, significantly mediated the association between obesity and symptoms of depression. The association between obesity and symptoms of anxiety and stress was significantly mediated by body investment difficulties related to body image concerns.ConclusionsThe current study brings evidence on specific dimensions of emotion regulation and body image that play a key role for the co-occurrence of mental health problems in individuals with obesity.IntroductionThere is still paucity of knowledge about which factors can mediate the link between obesity and mental health problems. This study aimed to investigate psychological mediators of the association between different weight profiles (healthy, overweight, and obesity) and symptoms of depression, anxiety, and stress.MethodsA sample of 407 adults (≥18 years old) with different weight profiles recruited from general population was assessed for symptoms of depression, anxiety, and stress, and dimensions of emotion regulation and body investment/body image. Robust regression and robust mediation analyses were employed to investigate predictors and mediators of mental health outcomes in relation to different weight profiles.ResultsBody investment difficulties in relation to body image and body care, and emotion regulation difficulties related to a tendency towards negative secondary responses to negative emotions, and/or denial of distress, significantly mediated the association between obesity and symptoms of depression. The association between obesity and symptoms of anxiety and stress was significantly mediated by body investment difficulties related to body image concerns.ConclusionsThe current study brings evidence on specific dimensions of emotion regulation and body image that play a key role for the co-occurrence of mental health problems in individuals with obesity.

Project description:BackgroundMorbid obesity is associated with an increased risk of thrombotic events, which has been attributed to increased thrombotic activity. Multiple mechanisms have been proposed to explain this increased risk, including an inflammatory state with upregulation of procoagulant and antifibrinolytic proteins. We therefore hypothesize that patients with morbid obesity are hypercoagulable and will revert to normal after bariatric surgery.ObjectivesTo evaluate changes in the hypercoagulable state after bariatric surgery.SettingUniversity Hospital, Bariatric Center of Excellence, United States.MethodsThromboelastography (TEG) data were collected on 72 subjects with morbid obesity, with 36 who had 6 months of follow-up after bariatric surgery. TEG data of 75 healthy subjects (HS) without obesity, recent trauma or surgery, acute infection, or chronic conditions (e.g., liver, cardiovascular, or kidney disease; cancer; diabetes; autoimmune or inflammatory disorders; and disorders of coagulation) were used for comparison. TEG was performed alone and with the addition of 75 and 150 ng/mL tissue plasminogen activator (tPA) to quantify fibrinolysis resistance (tPA-challenged TEG).ResultsThe bariatric surgery cohort had a median age of 40.5 years, a median body mass index of 44.6 kg/m2, and 90% female patients. Median body mass index reduced significantly 6 months post surgery but remained elevated compared with the HS group (31.4 versus 25.4 kg/m2, P < .0001). At 6 months post surgery, subjects had longer reaction time (mean difference, 1.3; P = .02), lower maximum amplitude (-2.4, P = .01), and increased fibrinolysis with low-dose (3.1, P < .0001) and high-dose tPA-challenged TEG (9, P < .0001). Compared with HS, the postsurgery TEG values were still more likely to be abnormal (all P < .05).ConclusionsPatients with morbid obesity form stronger clots more rapidly and are more resistant to fibrinolysis than subjects without obesity. Bariatric surgery significantly improved the hypercoagulable profile and fibrinolysis resistance of morbid obesity.

Dataset Information

Impact of bariatric surgery on depression, anxiety and stress symptoms among patients with morbid obesity: international multicentre study in Poland and Germany.

Background

Aims

Method

Results

Conclusions

Publications

Impact of bariatric surgery on depression, anxiety and stress symptoms among patients with morbid obesity: international multicentre study in Poland and Germany.

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