Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Sarawak, Malaysia.
Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Diabetes Metab Res Rev. 2021 Nov;37(8):e3458. doi: 10.1002/dmrr.3458. Epub 2021 May 4.
We aimed to examine if bariatric surgery was associated with a reduction in the prevalence of depressive and anxiety symptoms among people with obesity.
We pooled data from 49 studies involving 11,255 people with obesity who underwent bariatric surgery. The study outcomes were the prevalence of depressive and anxiety symptoms among these patients pre- and post-surgery.
There was a significant reduction in body mass index (BMI) post-operatively (pooled d+: -13.3 kg/m [95% confidence interval [CI] 15.19, -11.47], p < 0.001). The pooled proportion of patients with anxiety symptoms reduced from 24.5% pre-operatively to 16.9% post-operatively, with an odds ratio (OR) of 0.58 (95% CI 0.51, 0.67, p < 0.001). The reduction remained significant in women aged ≥40 years and irrespective of post-operative BMI. There were significant reductions in Hospital Anxiety and Depression Score (HADS) (anxiety component) by 0.64 (pooled d+: -0.64 [95% CI -1.06, -0.22], p = 0.003) and Generalized Anxiety Disorder Assessment-7 score by 0.54 (pooled d+: -0.54 [95% CI -0.64, -0.44], p < 0.001). The pooled proportion of depressive symptoms reduced from 34.7% pre-operatively to 20.4% post-operatively, with an OR of 0.49 (95% CI 0.37, 0.65, p < 0.001). The reduction remained significant irrespective of patient's age and post-operative BMI. There were also significant reductions in HADS score (depressive component) (pooled d+: -1.34 [95% CI -1.93, -0.76], p < 0.001), Beck's Depression Inventory score (pooled d+: -1.04 [95% CI -1.46, -0.63], p < 0.001) and Patient Health Questionnaire-9 score (pooled d+: -1.11 [95% CI -1.21, -1.01], p < 0.001).
Bariatric surgery was associated with significant reduction in the prevalence and severity of depressive and anxiety symptoms among people with obesity.
本研究旨在探讨减重手术是否与肥胖患者抑郁和焦虑症状的发生率降低相关。
我们汇总了 49 项研究的数据，共纳入了 11255 名接受减重手术的肥胖患者。研究结局为这些患者术前和术后抑郁和焦虑症状的发生率。
术后体重指数（BMI）显著下降（合并 d+：-13.3kg/m[95%置信区间（CI）15.19，-11.47]，p<0.001）。术前焦虑症状患者的比例为 24.5%，术后降至 16.9%，优势比（OR）为 0.58（95%CI 0.51，0.67，p<0.001）。≥40 岁的女性和术后 BMI 无差异的患者中，这种降低仍然显著。医院焦虑和抑郁量表（HADS）（焦虑分量表）降低 0.64（合并 d+：-0.64[95%CI-1.06，-0.22]，p=0.003），广泛性焦虑障碍评估-7 量表（GAD-7）降低 0.54（合并 d+：-0.54[95%CI-0.64，-0.44]，p<0.001）。术前抑郁症状患者的比例为 34.7%，术后降至 20.4%，OR 为 0.49（95%CI 0.37，0.65，p<0.001）。不论患者年龄和术后 BMI 如何，这种降低仍然显著。HADS 评分（抑郁分量表）（合并 d+：-1.34[95%CI-1.93，-0.76]，p<0.001）、贝克抑郁自评量表（BDI）（合并 d+：-1.04[95%CI-1.46，-0.63]，p<0.001）和患者健康问卷-9 量表（PHQ-9）（合并 d+：-1.11[95%CI-1.21，-1.01]，p<0.001）也显著降低。
减重手术与肥胖患者抑郁和焦虑症状的发生率和严重程度的显著降低相关。
