Helen Booth1, Omar Khan2, A Toby Prevost1, Marcus Reddy3, Judith Charlton1, Martin C Gulliford4. 1. King׳s College London, Department of Primary Care and Public Health Sciences, Capital House, 42 Weston Street, London SE1 3QD, UK; NIHR Biomedical Research Centre at Guy׳s and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK. 2. Department of Surgery, Whittington Hospital, Magdala Avenue, London N19 5NF, UK. 3. Department of Surgery, St George׳s Hospital, Blackshaw Road, London SW17 0QT, UK. 4. King׳s College London, Department of Primary Care and Public Health Sciences, Capital House, 42 Weston Street, London SE1 3QD, UK; NIHR Biomedical Research Centre at Guy׳s and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK. Electronic address: martin.gulliford@kcl.ac.uk.
Abstract
BACKGROUND: Obesity is associated with depression. This study aimed to evaluate whether clinical depression is reduced after bariatric surgery (BS). METHODS: Obese adults who received BS procedures from 2002 to 2014 were sampled from the UK Clinical Practice Research Datalink. An interrupted time series design, with matched controls, was conducted from three years before, to a maximum of seven years after surgery. Controls were matched for body mass index (BMI), age, gender and year of procedure. Clinical depression was defined as a medical diagnosis recorded in year, or an antidepressant prescribed in year to a participant ever diagnosed with depression. Adjusted odds ratios (AOR) were estimated. RESULTS: There were 3045 participants (mean age 45.9; mean BMI 44.0kg/m(2)) who received BS, including laparoscopic gastric banding in 1297 (43%), gastric bypass in 1265 (42%), sleeve gastrectomy in 477 (16%) and six undefined. Before surgery, 36% of BS participants, and 21% of controls, had clinical depression; between-group AOR, 2.02, 95%CI 1.75-2.33, P<0.001. In the second post-operative year 32% had depression; AOR, compared to time without surgery, 0.83 (0.76-0.90, P<0.001). By the seventh year, the prevalence of depression increased to 37%; AOR 0.99 (0.76-1.29, P=0.959). LIMITATIONS: Despite matching there were differences in depression between BS and control patients, representing the highly selective nature of BS. CONCLUSIONS: Depression is frequent among individuals selected to undergo bariatric surgery. Bariatric surgery may be associated with a modest reduction in clinical depression over the initial post-operative years but this is not maintained.
BACKGROUND: Obesity is associated with depression. This study aimed to evaluate whether clinical depression is reduced after bariatric surgery (BS). METHODS: Obese adults who received BS procedures from 2002 to 2014 were sampled from the UK Clinical Practice Research Datalink. An interrupted time series design, with matched controls, was conducted from three years before, to a maximum of seven years after surgery. Controls were matched for body mass index (BMI), age, gender and year of procedure. Clinical depression was defined as a medical diagnosis recorded in year, or an antidepressant prescribed in year to a participant ever diagnosed with depression. Adjusted odds ratios (AOR) were estimated. RESULTS: There were 3045 participants (mean age 45.9; mean BMI 44.0kg/m(2)) who received BS, including laparoscopic gastric banding in 1297 (43%), gastric bypass in 1265 (42%), sleeve gastrectomy in 477 (16%) and six undefined. Before surgery, 36% of BS participants, and 21% of controls, had clinical depression; between-group AOR, 2.02, 95%CI 1.75-2.33, P<0.001. In the second post-operative year 32% had depression; AOR, compared to time without surgery, 0.83 (0.76-0.90, P<0.001). By the seventh year, the prevalence of depression increased to 37%; AOR 0.99 (0.76-1.29, P=0.959). LIMITATIONS: Despite matching there were differences in depression between BS and control patients, representing the highly selective nature of BS. CONCLUSIONS:Depression is frequent among individuals selected to undergo bariatric surgery. Bariatric surgery may be associated with a modest reduction in clinical depression over the initial post-operative years but this is not maintained.
Authors: Valerie A Smith; Matthew L Maciejewski; Theodore S Z Berkowitz; James E Mitchell; Chuan-Fen Liu; Katharine A Bradley; Maren K Olsen; Edward L Livingston; David E Arterburn Journal: Ann Surg Date: 2022-07-06 Impact factor: 13.787
Authors: Jorge Pedro; João Sérgio Neves; Maria João Ferreira; Vanessa Guerreiro; Daniela Salazar; Sara Viana; Fernando Mendonça; Maria Manuel Silva; Isabel Brandão; Sandra Belo; Paula Freitas; Ana Varela; Davide Carvalho Journal: Obes Facts Date: 2020-03-31 Impact factor: 3.942