Kouidrat Youssef, Amad Ali, Stubbs Brendon, Moore Suzan, Gaughran Fiona
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.
Department of Nutrition and Obesity, AP-HP, Maritime Hospital, 62600, Berck, France.
Obes Surg. 2017 Jul;27(7):1889-1895. doi: 10.1007/s11695-017-2715-5.
People with schizophrenia or bipolar disorder (BD) exhibit very high levels of obesity. Little is known about the potential benefits/risks of obesity surgery. We conducted a narrative review to summarize the available knowledge on bariatric surgery in people with schizophrenia or BD.
A systematic search was conducted of major electronic databases from inception to October 2016 for studies investigating bariatric surgery among people with schizophrenia or BD. Data were presented in a narrative synthesis and future research strategies proposed.
The electronic database searches identified 44 records. Eight studies (BD, n = 265; schizophrenia: n = 14) were included with a mean study length of 15.7 months (12-24). Seven found that bariatric surgery resulted in weight loss in those with psychiatric disorders with an excess weight loss ranging -31 to -70%. Six studies found that weight loss from bariatric surgery was similar in people with schizophrenia or BD versus controls. However, most of the studies limited their outcomes to only weight loss and did not measure whether obesity surgery affected the status and treatment of psychiatric symptoms. Although few adverse events were reported among patients with BD, data from two studies demonstrated no significant deterioration of psychiatric symptoms post-surgery in people with schizophrenia.
Growing evidence suggests that bariatric surgery may improve short-term weight status among people with BD. However, given the paucity of studies for schizophrenia, and the lack of information on medium-to long-term results, future large-scale high-quality studies are required.
精神分裂症或双相情感障碍（BD）患者的肥胖率非常高。关于肥胖症手术的潜在益处/风险知之甚少。我们进行了一项叙述性综述，以总结关于精神分裂症或双相情感障碍患者接受减肥手术的现有知识。
对主要电子数据库进行系统检索，检索时间从建库至2016年10月，以查找关于精神分裂症或双相情感障碍患者接受减肥手术的研究。数据以叙述性综合形式呈现，并提出了未来的研究策略。
电子数据库检索共识别出44条记录。纳入了八项研究（双相情感障碍患者265例；精神分裂症患者14例），平均研究时长为15.7个月（12 - 24个月）。七项研究发现，减肥手术使精神疾病患者体重减轻，超重减轻幅度在31%至70%之间。六项研究发现，精神分裂症或双相情感障碍患者接受减肥手术后的体重减轻情况与对照组相似。然而，大多数研究仅将结果局限于体重减轻，并未衡量肥胖症手术是否影响精神症状的状态和治疗。虽然双相情感障碍患者中报告的不良事件较少，但两项研究的数据表明，精神分裂症患者术后精神症状无明显恶化。
越来越多的证据表明，减肥手术可能改善双相情感障碍患者的短期体重状况。然而，鉴于针对精神分裂症的研究较少，且缺乏中长期结果的信息，未来需要进行大规模高质量研究。
