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Depression Before and After Bariatric Surgery in Low-Income Patients: the Utility of the Beck Depression Inventory

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Abstract

Background

The prevalence of psychological disorders in bariatric surgery candidates is well established, where anxiety and depression are commonly observed. Depression prevalence and evolution after gastric bypass, and its impact on weight loss, have been less explored, especially among low-income patients.

Methods

A retrospective study with low-income patients undergoing bariatric surgery from 2015 to 2016. A comparative analysis of preoperative depression (the Beck Depression Inventory II) was performed and compared at 6 and 12 months. A demographic and weight loss analysis was also performed.

Results

Seventy-three patients were included. Female sex comprised 76.7% of cases, and baseline depression was present in 45.2%, being severe in 2.7%. The analysis at 6 months showed Beck’s score improvement (12.3 baseline vs. 4.2 points at 6 months, p = 0.006), as well as for individual items (excepting irritability). At 12 months, the mean score was 5 points, without difference vs. 6 months. At 6 and 12 months, depression (any degree) was present in 9.6 and 8.6%, corresponding to percentage change rates of − 65.8 and − 59.3%. Only one patient (2.7%) presented severe depression. Depression status before surgery had no influence in weight loss amount at 12 months.

Conclusion

Almost half of bariatric surgery candidates have some degree of depression that improves dramatically soon after bariatric surgery. Such change continues stable during the first year. Improvement was independent of gender, and depression has no influence on weight loss. In low-income bariatric patients, depression is lower than reports from developed countries, but similar improvement has been observed.

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References

  1. Pareek M, Schauer PR, Kaplan LM, et al. Metabolic surgery: weight loss, diabetes, and beyond. J Am Coll Cardiol. 2018;71(6):670–87.

    Article  PubMed  Google Scholar 

  2. Gadde KM, Martin CK, Berthoud HR, et al. Obesity: pathophysiology and management. J Am Coll Cardiol. 2018;71(1):69–84.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Muhlhans B, Horbach T, de Zwaan M. Psychiatric disorders in bariatric surgery candidates: a review of the literature and results of a German prebariatric surgery sample. Gen Hosp Psychiatry. 2009;31(5):414–21.

    Article  PubMed  Google Scholar 

  4. Rosik CH. Psychiatric symptoms among prospective bariatric surgery patients: rates of prevalence and their relation to social desirability, pursuit of surgery, and follow-up attendance. Obes Surg. 2005;15(5):677–83.

    Article  PubMed  Google Scholar 

  5. Hayden MJ, Dixon JB, Dixon ME, et al. Characterization of the improvement in depressive symptoms following bariatric surgery. Obes Surg. 2011;21(3):328–35.

    Article  PubMed  Google Scholar 

  6. Schowalter M, Benecke A, Lager C, et al. Changes in depression following gastric banding: a 5- to 7-year prospective study. Obes Surg. 2008;18(3):314–20.

    Article  PubMed  Google Scholar 

  7. Mamplekou E, Komesidou V, Bissias C, et al. Psychological condition and quality of life in patients with morbid obesity before and after surgical weight loss. Obes Surg. 2005;15(8):1177–84.

    Article  CAS  PubMed  Google Scholar 

  8. van Hout GC, Boekestein P, Fortuin FA, et al. Psychosocial functioning following bariatric surgery. Obes Surg. 2006;16(6):787–94.

    Article  PubMed  Google Scholar 

  9. Kalarchian MA, Marcus MD, Levine MD, et al. Relationship of psychiatric disorders to 6-month outcomes after gastric bypass. Surg Obes Relat Dis. 2008;4(4):544–9.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mitchell JE, Selzer F, Kalarchian MA, et al. Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis. 2012;8(5):533–41.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Wimmelmann CL, Dela F, Mortensen EL. Psychological predictors of weight loss after bariatric surgery: a review of the recent research. Obes Res Clin Pract. 2014;8(4):e299–313.

    Article  PubMed  Google Scholar 

  12. Dawes AJ, Maggard-Gibbons M, Maher AR, et al. Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis. JAMA. 2016;315(2):150–63.

    Article  CAS  PubMed  Google Scholar 

  13. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51(1):8–19.

    Article  CAS  PubMed  Google Scholar 

  14. Hsu LK, Benotti PN, Dwyer J, et al. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 1998;60(3):338–46.

    Article  CAS  PubMed  Google Scholar 

  15. Krukowski RA, Friedman KE, Applegate KL. The utility of the Beck Depression Inventory in a bariatric surgery population. Obes Surg. 2010;20(4):426–31.

    Article  PubMed  Google Scholar 

  16. Muñiz JF-HJ. La opinión de los psicólogos Españoles sobre el uso de los test. Papeles del Psicólogo. 2010;31:108–21.

    Google Scholar 

  17. Moussavi S, Chatterji S, Verdes E, et al. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590):851–8.

    Article  PubMed  Google Scholar 

  18. Sogg S, Lauretti J, West-Smith L. Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients. Surg Obes Relat Dis. 2016;12(4):731–49.

    Article  PubMed  Google Scholar 

  19. Tindle HA, Omalu B, Courcoulas A, et al. Risk of suicide after long-term follow-up from bariatric surgery. Am J Med. 2010;123(11):1036–42.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rubino F, Nathan DM, Eckel RH, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Surg Obes Relat Dis. 2016;12(6):1144–62.

    Article  PubMed  Google Scholar 

  21. Maggard-Gibbons M, Maglione M, Livhits M, et al. Bariatric surgery for weight loss and glycemic control in nonmorbidly obese adults with diabetes: a systematic review. JAMA. 2013;309(21):2250–61.

    Article  CAS  PubMed  Google Scholar 

  22. Gastrointestinal surgery for severe obesity. Proceedings of a National Institutes of Health Consensus Development Conference. March 25–27, 1991, Bethesda, MD. Am J Clin Nutr 1992;55(2 Suppl):487S–619S.

  23. Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP, Pilkonis PA, Ringham RM, et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. The Am J Psychiatr 2007;164(2):328–334; quiz 74

    Article  PubMed  Google Scholar 

  24. Kubik JF, Gill RS, Laffin M, et al. The impact of bariatric surgery on psychological health. J Obes. 2013;2013:837989.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Endocr Pract. 2013;19(2):337–72.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Beck AT, Guth D, Steer RA, et al. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behav Res Ther. 1997;35(8):785–91.

    Article  CAS  PubMed  Google Scholar 

  27. Contreras-Valdez JAH-GL, Freyre MA. Validez de constructo del Inventario de Depresión de Beck II para adolescentes. Terapia psicológica. 2015;33(3):195–2013.

    Article  Google Scholar 

  28. Kessler RC, Birnbaum HG, Shahly V, et al. Age differences in the prevalence and co-morbidity of DSM-IV major depressive episodes: results from the WHO World Mental Health Survey Initiative. Depression Anxiety. 2010;27(4):351–64.

    Article  PubMed  Google Scholar 

  29. Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119–38.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Bello M, Puentes-Rosas E, Medina-Mora ME, et al. Prevalence and diagnosis of depression in Mexico. Salud publica de Mexico. 2005;47(Suppl 1):S4–11.

    PubMed  Google Scholar 

  31. Friedman MA, Brownell KD. Psychological correlates of obesity: moving to the next research generation. Psychol Bull. 1995;117(1):3–20.

    Article  CAS  PubMed  Google Scholar 

  32. de Zwaan M, Mitchell JE, Howell LM, et al. Characteristics of morbidly obese patients before gastric bypass surgery. Compr Psychiatry. 2003;44(5):428–34.

    Article  PubMed  Google Scholar 

  33. Santry HP, Chin MH, Cagney KA, et al. The use of multidisciplinary teams to evaluate bariatric surgery patients: results from a national survey in the U.S.A. Obes Surg. 2006;16(1):59–66.

    Article  PubMed  Google Scholar 

  34. Bauchowitz AU, Gonder-Frederick LA, Olbrisch ME, et al. Psychosocial evaluation of bariatric surgery candidates: a survey of present practices. Psychosom Med. 2005;67(5):825–32.

    Article  PubMed  Google Scholar 

  35. Morgan DJ, Ho KM. Incidence and risk factors for deliberate self-harm, mental illness, and suicide following bariatric surgery: a state-wide population-based linked-data cohort study. Ann Surg. 2017;265(2):244–52.

    Article  PubMed  Google Scholar 

  36. Gorin AA, Raftopoulos I. Effect of mood and eating disorders on the short-term outcome of laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2009;19(12):1685–90.

    Article  PubMed  Google Scholar 

  37. Bhatti JA, Nathens AB, Thiruchelvam D, et al. Self-harm emergencies after bariatric surgery: a population-based cohort study. JAMA Surg. 2016;151(3):226–32.

    Article  PubMed  Google Scholar 

  38. Merrell J, Ashton K, Windover A, et al. Psychological risk may influence drop-out prior to bariatric surgery. Surg Obes Relat Dis. 2012;8(4):463–9.

    Article  PubMed  Google Scholar 

  39. Estudios Económicos de la OCDE: México. Available from: www.oecd.org/eco/surveys/economic-survey-méxico.htm.

  40. Medina-Mora ME, Borges G, Benjet C, et al. Psychiatric disorders in Mexico: lifetime prevalence in a nationally representative sample. British J Psychiatry. 2007;190:521–8.

    Article  Google Scholar 

  41. Munoz DJ, Chen E, Fischer S, et al. Considerations for the use of the Beck Depression Inventory in the assessment of weight-loss surgery seeking patients. Obes Surg. 2007;17(8):1097–101.

    Article  PubMed  Google Scholar 

  42. Bocchieri LE, Meana M, Fisher BL. A review of psychosocial outcomes of surgery for morbid obesity. J Psychosom Res. 2002;52(3):155–65.

    Article  PubMed  Google Scholar 

  43. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  PubMed  Google Scholar 

  44. Herpertz S, Kielmann R, Wolf AM, et al. Does obesity surgery improve psychosocial functioning? A systematic review. Int J Obes Relat Metab Disord. 2003;27(11):1300–14.

    Article  CAS  PubMed  Google Scholar 

  45. Semanscin-Doerr DA, Windover A, Ashton K, et al. Mood disorders in laparoscopic sleeve gastrectomy patients: does it affect early weight loss? Surg Obes Relat Dis. 2010;6(2):191–6.

    Article  PubMed  Google Scholar 

  46. Ghoneim MM, O’Hara MW. Depression and postoperative complications: an overview. BMC Surg. 2016;16:5.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Carlos Zerrweck.

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Alabi, F., Guilbert, L., Villalobos, G. et al. Depression Before and After Bariatric Surgery in Low-Income Patients: the Utility of the Beck Depression Inventory. OBES SURG 28, 3492–3498 (2018). https://doi.org/10.1007/s11695-018-3371-0

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