Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil; Centro Universitário Fundação Santo André, Santo André, SP, Brazil.
Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2024 Oct 20;79:100517. doi: 10.1016/j.clinsp.2024.100517. eCollection 2024.
To evaluate the evolution of Psychiatric Disorders (PD) and weight loss at different postoperative intervals up to 9 years after Metabolic and Bariatric Surgery (MBS).
This is a nine-year longitudinal study conducted at a single university-based bariatric center in Brazil. The Generalized Estimating Equation (GEE) and multiple linear regression models were used to evaluate the proportion of lifetime PD according to TPS, and its relationship with weight. The Structured Clinical Interview for DSM-5 assessed the PD and the percentage of Excess Lost Weight (%EWL) for weight changes. The study included 142 participants who had undergone MBS, mostly women (82 %), mean age of 52 years.
Depression and anxiety disorders were the most common PD. Regardless of the time elapsed since MBS, there was an increase of 32 % in lifetime mood disorders, bipolar disorders, and eating disorders. The average EWL for Time Post-Surgery (TPS) ≤ 24 months was 69 % and remained consistent until 72 months; after was 57 % and 58 % for ≤ 72 and 96 months, respectively. There was not a significant association between %EWL and PD when controlling for sex, age, and time post-surgery.
Psychiatric disorders can be associated and remain prevalent, regardless of time post-surgery; however, this does not significantly impact weight losss maintenance. It is recommended that individuals who have undergone MBS be monitored and supported over an extended period to address psychiatric comorbidities.
评估代谢和减重手术(MBS)后不同时间点的精神障碍(PD)和体重减轻的演变情况,随访时间最长达 9 年。
这是一项在巴西的单所大学减重中心进行的为期 9 年的纵向研究。使用广义估计方程(GEE)和多元线性回归模型,根据 TPS 评估终生 PD 的比例及其与体重的关系。使用 DSM-5 结构临床访谈评估 PD 和体重变化的超重减轻百分比(%EWL)。该研究纳入了 142 名接受过 MBS 的参与者,其中大多数为女性(82%),平均年龄为 52 岁。
抑郁和焦虑障碍是最常见的 PD。无论 MBS 后时间长短,心境障碍、双相障碍和饮食障碍的终生发病率均增加了 32%。术后时间(TPS)≤24 个月时的平均 EWL 为 69%,直到 72 个月时仍保持一致;之后分别为≤72 个月和 96 个月时的 57%和 58%。在控制性别、年龄和术后时间后,%EWL 与 PD 之间没有显著关联。
精神障碍可能与手术时间无关且持续流行;然而,这并不会显著影响体重减轻的维持。建议对接受过 MBS 的个体进行长期监测和支持,以解决精神共病问题。