Mood disorders in laparoscopic sleeve gastrectomy patients: does it affect early weight loss?
ABSTRACT Research has demonstrated that laparoscopic Roux-en-Y gastric bypass patients with a lifetime history of a mood disorder have a lower percentage of excess weight loss (%EWL) compared with patients without this lifetime history. No studies have examined the effect of psychiatric history on postoperative outcomes among laparoscopic sleeve gastrectomy (LSG) patients. The objectives of the present study were to determine whether mood disorders relate to the first year of weight loss for patients undergoing LSG at an academic medical center.
A total of 104 patients (78.6% white and 71.2% women), with a median body mass index of 60.35 kg/m(2) (range 31.37-129.14) underwent LSG. The patients were prospectively followed up at 1, 3, 6, 9, and 12 months. The semistructured preoperative psychiatric evaluations demonstrated that 43.1% had a current, and 62.5% a lifetime, diagnosis of a mood disorder.
LSG patients with current mood disorders had a significantly lower %EWL than patients without a psychiatric diagnosis at the 1-, 3-, 6-, and 9-month follow-up visits. LSG patients with a lifetime history of a mood disorder had a significantly lower %EWL than patients without psychiatric diagnosis at the 1-, 9-, and 12-month follow-up examinations. However, after removing patients with bipolar disorder from the analyses, no significant differences were found in the %EWL between patients with and without a lifetime history of depressive disorders.
Consistent with the laparoscopic Roux-en-Y gastric bypass findings, a lifetime history of mood disorders appears to be associated with significantly less weight loss in LSG patients. These findings highlight the importance of the psychiatric assessment in bariatric patients. Additionally, patients with a current or lifetime history of mood disorders might need additional pre- and postoperative care to improve their outcomes.
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ABSTRACT: Bariatric surgery has been consistently shown to be effective in long-term marked weight loss and in bringing significant improvement to medical comorbidities such as metabolic syndrome. Empirical data suggest a high prevalence of psychiatric disorders among bariatric surgery candidates. In this review, we focus on the studies published recently with a high impact on our understanding of the role of psychiatry in bariatric surgery.Current Opinion in Psychiatry 07/2014; · 3.55 Impact Factor
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ABSTRACT: Background Presurgical Psychological Screening (PPS) is used to identify factors that may impact postoperative adherence and surgical outcomes in bariatric surgery candidates. Minnesota Multiphasic Personality Inventory – 2 Restructured Form (MMPI-2-RF) findings have demonstrated utility for this task. Objectives To explore whether there are clinically meaningful gender, ethnicity, or age differences in pre-surgical MMPI-2-RF scores and the validity of these scores in bariatric surgery candidates. Setting Cleveland Clinic Bariatric and Metabolic Institute, United States Methods The sample was composed of 872 men and 2337 women. Ethnicity/race groups included 2,204 Caucasian, 744 African American, and 96 Hispanic individuals. Ages groups included 18-35 year olds (n= 454), 36-49 year olds (n = 1154), 50-64 year olds, (n = 1246), 65 years old or older (n = 355). Validity data, obtained via a retrospective chart review, were available for a subset patients (n=1,268) who were similarly distributed. Step-down hierarchical regression analyses were conducted to assess for differential validity. Results Bariatric surgery candidates produced comparable MMPI-2-RF scores in all subsamples, indicating that the test norms generalize across demographic groups. Validity findings were also generally comparable, indicating that MMPI-2-RF scores have the same interpretive implications in demographically diverse subgroups of bariatric surgery candidates. Conclusions The MMPI-2-RF can assist in presurgical psychological screening of demographically diverse bariatric surgery candidates. http://www.soard.org/article/S1550-7289(14)00393-1/abstract#article-footnote-☆☆Surgery for Obesity and Related Diseases 10/2014; · 4.94 Impact Factor
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ABSTRACT: The purpose of the present study is to evaluate the impact of a health psychology-led bariatric rehabilitation service (BRS) on patient weight loss following bariatric surgery at 1 year.Obesity Surgery 09/2014; · 3.74 Impact Factor