Sanjeev Sockalingam1, Raed Hawa2, Susan Wnuk3, Vincent Santiago4, Matthew Kowgier5, Timothy Jackson6, Allan Okrainec6, Stephanie Cassin7. 1. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada; Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada. Electronic address: sanjeev.sockalingam@uhn.ca. 2. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada; Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada. 3. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada. 4. Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada. 5. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 6. Bariatric Surgery Program, Toronto Western Hospital, Toronto, Ontario, Canada; Division of General Surgery, University Health Network, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. 7. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada; Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
Abstract
OBJECTIVES: Studies exploring the impact of pre-surgery psychiatric status as a predictor of health related quality of life (QOL) after bariatric surgery have been limited to short-term follow-up and variable use of psychosocial measures. We examined the effect of pre-operative psychiatric factors on QOL and weight loss 2-years after surgery. METHODS: 156 patients participated in this prospective cohort study, the Toronto Bariatric Psychosocial Cohort Study, between 2010 and 2014. Patients were assessed pre-surgery for demographic factors, weight, psychiatric diagnosis using the MINI International Neuropsychiatric Interview and symptom measures for QOL, depression and anxiety at pre-surgery and at 1 and 2years post-surgery. RESULTS: At 2-years post-bariatric surgery, patients experienced a significant decrease in mean weight (-48.43kg, 95% [-51.1, -45.76]) and an increase only in physical QOL (+18.91, 95% [17.01, 20.82]) scores as compared to pre-surgery. Multivariate regression analysis identified pre-surgery physical QOL score (p<0.001), younger age (p=0.005), and a history of a mood disorder as significant predictors of physical QOL. Only a history of a mood disorder (p=0.032) significantly predicted mental QOL (p=0.006). Pre-surgery weight (p<0.001) and a history of a mood disorder (p=0.047) were significant predictors of weight loss 2-years post-surgery. CONCLUSIONS: Bariatric surgery had a sustained impact on physical QOL but not mental QOL at 2-years post-surgery. A history of mood disorder unexpectedly increased physical QOL scores and weight loss following surgery. Further research is needed to determine if these results are due to bariatric surgery candidate selection within this program.
OBJECTIVES: Studies exploring the impact of pre-surgery psychiatric status as a predictor of health related quality of life (QOL) after bariatric surgery have been limited to short-term follow-up and variable use of psychosocial measures. We examined the effect of pre-operative psychiatric factors on QOL and weight loss 2-years after surgery. METHODS: 156 patients participated in this prospective cohort study, the Toronto Bariatric Psychosocial Cohort Study, between 2010 and 2014. Patients were assessed pre-surgery for demographic factors, weight, psychiatric diagnosis using the MINI International Neuropsychiatric Interview and symptom measures for QOL, depression and anxiety at pre-surgery and at 1 and 2years post-surgery. RESULTS: At 2-years post-bariatric surgery, patients experienced a significant decrease in mean weight (-48.43kg, 95% [-51.1, -45.76]) and an increase only in physical QOL (+18.91, 95% [17.01, 20.82]) scores as compared to pre-surgery. Multivariate regression analysis identified pre-surgery physical QOL score (p<0.001), younger age (p=0.005), and a history of a mood disorder as significant predictors of physical QOL. Only a history of a mood disorder (p=0.032) significantly predicted mental QOL (p=0.006). Pre-surgery weight (p<0.001) and a history of a mood disorder (p=0.047) were significant predictors of weight loss 2-years post-surgery. CONCLUSIONS: Bariatric surgery had a sustained impact on physical QOL but not mental QOL at 2-years post-surgery. A history of mood disorder unexpectedly increased physical QOL scores and weight loss following surgery. Further research is needed to determine if these results are due to bariatric surgery candidate selection within this program.
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Authors: Mohamad Baheeg; Saed A Elgohary; Mohamed Tag-Eldin; Ahmed M E Hegab; Mahmoud S Shehata; Esam M Osman; Mohammed Eid; Yunus Abdurakhmanov; Mohamed Lamlom; Hazem A Ali; Ahmed Elhawary; Momen Mahmoud; Mostafa Basiony; Yasien Mohammmed; Abdulkarim Hasan Journal: Ann Med Surg (Lond) Date: 2022-01-04