Department of Surgery, Henry Ford Health System, Detroit, Michigan; Behavioral Health, Henry Ford Health System, Detroit, Michigan.
Department of Surgery, Henry Ford Health System, Detroit, Michigan; Behavioral Health, Henry Ford Health System, Detroit, Michigan.
Surg Obes Relat Dis. 2021 Feb;17(2):366-371. doi: 10.1016/j.soard.2020.09.024. Epub 2020 Sep 22.
Findings regarding longer term symptoms of depression and the impact of depression on outcomes such as weight loss and patient satisfaction, are mixed or lacking.
This study sought to understand the relationship between depression, weight loss, and patient satisfaction in the two years after bariatric surgery.
This study used data from a multi-institutional, statewide quality improvement collaborative of 45 different bariatric surgery sites.
Participants included patients (N = 1991) who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2015-2018. Participants self-reported symptoms of depression (Patient Health Questionnaire-8 [PHQ-8]), satisfaction with surgery, and weight presurgery and 1 year and 2 years postsurgery.
Compared to presurgery, fewer patients' PHQ-8 scores indicated clinically significant depression (PHQ-8≥10) at 1 year (P < .001; 14.3% versus 5.1%) and 2 years postsurgery (P < .0001; 8.7%). There was a significant increase in the prevalence of clinical depression from the first to second year postsurgery (P < .0001; 5.1% versus 8.7%). Higher PHQ-8 at baseline was related to less weight loss (%Total Weight Loss [%TWL] and %Excess Weight Loss [%EWL]) at 1 year postsurgery (P < .001), with a trend toward statistical significance at 2 years (P = .06). Postoperative depression was related to lower %TWL and %EWL, and less reduction in body mass index (BMI) at 1 year (P < .001) and 2 years (P < .0001). Baseline and postoperative depression were associated with lower patient satisfaction at both postoperative time points.
This study suggests improvements in depression up to 2 years postbariatric surgery, although it appears that the prevalence of depression increases after the first year. Depression, both pre- and postbariatric surgery, may impact weight loss and patient satisfaction.
关于抑郁的长期症状以及抑郁对减肥和患者满意度等结果的影响的研究结果存在差异或缺乏。
本研究旨在了解减肥手术后两年内抑郁、减肥和患者满意度之间的关系。
本研究使用了来自 45 个不同减肥手术地点的多机构、全州质量改进合作的数据。
参与者包括 2015 年至 2018 年间接受 Roux-en-Y 胃旁路术（RYGB）或袖状胃切除术（SG）的患者（N=1991）。参与者自我报告抑郁症状（患者健康问卷-8 [PHQ-8]）、对手术的满意度以及手术前、手术后 1 年和 2 年的体重。
与手术前相比，术后 1 年（P<.001；14.3%比 5.1%）和 2 年（P<.0001；8.7%）时，较少的患者 PHQ-8 评分表明存在临床显著抑郁（PHQ-8≥10）。术后第一年到第二年，临床抑郁的患病率显著增加（P<.0001；5.1%比 8.7%）。基线时 PHQ-8 较高与术后 1 年时体重减轻较少有关（%总体重减轻 [%TWL]和%超重减轻 [%EWL]）（P<.001），在第 2 年时呈统计学趋势（P=.06）。术后抑郁与术后 1 年（P<.001）和 2 年（P<.0001）时 TWL 和 EWL 减少较少以及 BMI 降低较少有关。基线和术后抑郁与术后两个时间点的患者满意度较低有关。
本研究表明减肥手术后抑郁有所改善，尽管似乎术后第一年抑郁的患病率增加。术前和术后的抑郁都可能影响减肥和患者满意度。
