Five-Year Changes in Psychiatric Treatment Status and Weight-Related Comorbidities Following Bariatric Surgery in a Veteran Population
Source: Obesity Surgery, Volume 22, Number 11, November 2012 , pp. 1734-1741(8)
Abstract:Although bariatric surgery is an established treatment for obesity, less is known regarding the long-term effects of surgery on psychiatric function. This paper reports changes in psychiatric treatment status, weight, and weight-related comorbidities over 5 years of follow-up among a population of veterans completing bariatric surgery.
We assessed 55 veterans undergoing bariatric surgery at a single Veteran Affairs medical center for 5 years post-surgery. Patients completed a pre-surgery clinical interview with a licensed psychologist. Using computerized medical records, we tracked pre- to post-surgery involvement with antidepressants, anxiolytics, psychotherapies, and overall psychiatric treatment visits along with changes in weight and metabolic function.
Rates of antidepressant use and/or involvement with psychotherapy for depression declined from 56.4 % at pre-surgery to 34.6 % at 5 years post-surgery, p = 0.01. Anxiolytic use and/or involvement with psychotherapy for anxiety, however, increased from 23.6 to 32.7 % pre- to 5 years post-surgery. Average psychiatric treatment volume remained similar to pre-surgery status across follow-up. These mixed indicators of psychiatric improvement occurred despite marked metabolic improvements from surgery. Mean percent excess weight loss = 51.7 and 41.3 (1 and 5 years post-surgery, respectively), systolic blood pressure (−6.8 mmHg (14.3)/−6.1 mmHg (12.8), respectively), glucose levels (−18.6 mg/dL (30.2)/−10.0 mg/dL (25.9), respectively), triglycerides (−78.2 mg/dL (96.7)/−69.1 mg/dL (102.2), respectively) and high-density lipoproteins (+7.1 (9.9)/+11.3 (11.3), respectively) levels each improved.
We report evidence of decreased antidepressant use and depression therapies following bariatric surgery, but no improvements on rates of anxiolytic use and anxiety therapies or on overall psychiatric treatment involvement. Despite metabolic improvements, bariatric patients with psychiatric histories may warrant ongoing attention to mental health.
Document Type: Research Article
Affiliations: 1: VA San Diego Healthcare System, Medical Center, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA, Email: email@example.com 2: Department of Psychology, Case Western Reserve University, Cleveland, USA 3: VA San Diego Healthcare System, Medical Center, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA 4: Department of Psychology, Stanford University, Stanford, USA 5: Department of Surgery, University of Texas Science Center, San Antonio, USA
Publication date: November 1, 2012