Quality of life among patients undergoing bariatric surgery: associations with mental health- A 1 year follow-up study of bariatric surgery patients

Haldis O Lier, Eva Biringer, Oddbjørn Hove, Bjarte Stubhaug, Tone Tangen, Haldis O Lier, Eva Biringer, Oddbjørn Hove, Bjarte Stubhaug, Tone Tangen

Abstract

Background: Preoperative mental health seems to have useful predictive value for Health Related Quality of Life (HRQOL) after bariatric surgery. The aim of the present study was to assess pre- and postoperative psychiatric disorders and their associations with pre- and postoperative HRQOL.

Method: Data were assessed before (n = 127) and one year after surgery (n = 87). Psychiatric disorders were assessed by Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview (SCID-II). HRQOL was assessed by the Short Form 36 (SF-36) questionnaire.

Results: Significant improvements were found in HRQOL from preoperative assessment to follow-up one year after surgery. For the total study population, the degree of improvement was statistically significant (p values < .001) for seven of the eight SF-36 subscales from preoperative assessment to follow-up one year after surgery. Patients without psychiatric disorders had no impairments in postoperative HRQOL, and patients with psychiatric disorders that resolved after surgery had small impairments on two of the eight SF-36 subscales compared to the population norm (all effect sizes < .5) at follow-up one year after surgery. Patients with psychiatric disorders that persisted after surgery had impaired HRQOL at follow-up one year after surgery compared to the population norm, with effect sizes for the differences from moderate to large (all effect sizes ≥ .6).

Conclusion: This study reports the novel finding that patients without postoperative psychiatric disorders achieved a HRQOL comparable to the general population one year after bariatric surgery; while patients with postoperative psychiatric disorders did not reach the HRQOL level of the general population. Our results support monitoring patients with psychiatric disorders persisting after surgery for suboptimal improvements in quality of life after bariatric surgery.

Trial registration: The trial is registered at http://www.clinicaltrials.gov prior to patient inclusion (ProtocolID16280).

Trial registration: ClinicalTrials.gov NCT00635011.

References

    1. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–1737. doi: 10.1001/jama.292.14.1724.
    1. Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, Larsson B, Narbro K, Sjostrom CD, Sullivan CD, Wedel H. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–2693. doi: 10.1056/NEJMoa035622.
    1. Karlsson J, Taft C, Ryden A, Sjostrom L, Sullivan M. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Intl J of Obes. 2007;31:1248–1261. doi: 10.1038/sj.ijo.0803573.
    1. Roger Andersen J, Aasprang A, Bergsholm P, Sletteskog N, Vage V, Karin Natvig G. Health-related quality of life and paid work participation after duodenal switch. Obes Surg. 2010;20:340–345. doi: 10.1007/s11695-009-9837-3.
    1. Helmio M, Salminen P, Sintonen H, Ovaska J, Victorzon M. A 5-Year Prospective Quality of Life Analysis Following Laparoscopic Adjustable Gastric Banding for Morbid Obesity. Obes Surg. 2011. in press .
    1. Dymek MP, Le Grange D, Neven K, Alverdy J. Quality of life after gastric bypass surgery: a cross-sectional study. Obes Res. 2002;10:1135–1142. doi: 10.1038/oby.2002.154.
    1. Odom J, Zalesin KC, Washington TL, Miller WW, Hakmeh B, Zaremba DL, Altattan M, Balasubramaniam M, Gibbs DS, Krause KR, Chengelis DL, Franklin BA, McCullough PA. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20:349–356. doi: 10.1007/s11695-009-9895-6.
    1. Faria SL, de Oliveira Kelly E, Lins RD, Faria OP. Nutritional management of weight regain after bariatric surgery. Obes Surg. 2010;20:135–139. doi: 10.1007/s11695-008-9610-z.
    1. Muhlhans B, Horbach T, de Zwaan M. Psychiatric disorders in bariatric surgery candidates: a review of the literature and results of a German prebariatric surgery sample. Gen Hosp Psychiatry. 2009;31:414–421. doi: 10.1016/j.genhosppsych.2009.05.004.
    1. Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP, Pilkonis PA, Ringham RM, Soulakova JN, Weissfeld LA, Rofey DL. Psychiatric disorders among bariatric surgery candidates: Relationship to obesity and functional health status. American journal of Psychiatry. 2007;164:328–334. doi: 10.1176/appi.ajp.164.2.328.
    1. Scott KM, McGee MA, Wells JE, Oakley Browne MA, Scott KM, McGee MA, Wells JE, Oakley Browne MA. Obesity and mental disorders in the adult general population. J Psychosom Res. 2008;64:97–105. doi: 10.1016/j.jpsychores.2007.09.006.
    1. Patricia R, Kathryn H, Carlos G. Psychiatric Disorder Comorbidity and Association With Eating Disorders in Bariatric Surgery Patients: A Cross -Sectional Study Using Structured Interview-Based Diagnosis. J Clin Psychiatry. 2006;67:1080–1085. doi: 10.4088/JCP.v67n0710.
    1. Mauri M, Rucci P, Calderone A, Santini F, Oppo A, Romano A, Rinaldi S, Armani A, Polini M, Pinchera A, Cassano GB. Axis I and II disorders and quality of life in bariatric surgery candidates. J Clin Psych. 2008;69:295–301. doi: 10.4088/JCP.v69n0216.
    1. Benninghoven D, Kaduk A, Wiegand U, Specht T, Kunzendorf S, Jantschek G. Influence of anxiety on the course of heart disease after acute myocardial infarction - risk factor or protective function? Psychotherapy & Psychosomatics. 2006;75:56–61. doi: 10.1159/000089227.
    1. Roy-Byrne PP, Davidson KW, Kessler RC, Asmundson GJ, Goodwin RD, Kubzansky L, Lydiard RB, Massie MJ, Katon W, Laden SK, Stein MB. Anxiety disorders and comorbid medical illness. Gen Hosp Psychiatry. 2008;30:208–225. doi: 10.1016/j.genhosppsych.2007.12.006.
    1. Katon W, Lin EH, Kroenke K, Katon W, Lin EHB, Kroenke K. The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. Gen Hosp Psychiatry. 2007;29:147–155. doi: 10.1016/j.genhosppsych.2006.11.005.
    1. Mommersteeg PM, Kupper N, Denollet J. Type D personality is associated with increased metabolic syndrome prevalence and an unhealthy lifestyle in a cross-sectional Dutch community sample. BMC Public Health. 2010;10:714. doi: 10.1186/1471-2458-10-714.
    1. Chapman BP, Roberts B, Duberstein P. Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine. J Aging Res. 2011. pp. 24–Article ID 759170.
    1. Kalarchian MA, Marcus MD, Levine MD, Soulakova JN, Courcoulas AP, Wisinski MS. Relationship of psychiatric disorders to 6-month outcomes after gastric bypass. Surg Obes Relat Dis. 2008;4:544–549. doi: 10.1016/j.soard.2008.03.003.
    1. Kinzl JF, Schrattenecker M, Traweger C, Mattesich M, Fiala M, Biebl W. Psychosocial predictors of weight loss after bariatric surgery. Obes Surg. 2006;16:1609–1614. doi: 10.1381/096089206779319301.
    1. Masheb RM, White MA, Toth CM, Burke-Martindale CH, Rothschild B, Grilo CM. The prognostic significance of depressive symptoms for predicting quality of life 12 months after gastric bypass. Compr Psychiatry. 2007;48:231–236. doi: 10.1016/j.comppsych.2007.01.005.
    1. Van Hout GCM, h CAJM, Verschure SKM, Van Heck GL. Psychosocial Predictors of Success After Vertical Banded Gastroplasty. Obes Surg. 2009;19:701–707. doi: 10.1007/s11695-008-9446-6.
    1. Kinzl JF, Schrattenecker M, Traweger C, Aigner F, Fiala M, Biebl W. Quality of life in morbidly obese patients after surgical weight loss. Obes Surg. 2007;17:229–235. doi: 10.1007/s11695-007-9030-5.
    1. Legenbauer T, Petrak F, de Zwaan M, Herpertz S. Influence of depressive and eating disorders on short- and long-term course of weight after surgical and nonsurgical weight loss treatment. Compr Psychiatry. pp. 301–311.
    1. Lanyon RI, Maxwell BM. Predictors of outcome after gastric bypass surgery. Obes Surg. 2007;17:321–328. doi: 10.1007/s11695-007-9059-5.
    1. Lanyon RI, Maxwell BM, Kraft AJ, Lanyon RI, Maxwell BM, Kraft AJ. Prediction of long-term outcome after gastric bypass surgery. Obes Surg. 2009;19:439–445. doi: 10.1007/s11695-008-9740-3.
    1. Herpertz S, Kielmann R, Wolf AM, Hebebrand J, Senf W. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res. 2004;12:1554–1569. doi: 10.1038/oby.2004.195.
    1. Van Hout GCM, Verschure SKM, Van Heck GL. Psychosocial predictors of success following bariatric surgery. Obes Surg. 2005;15:552–560. doi: 10.1381/0960892053723484.
    1. White MA, Kalarchian MA, Masheb RM, Marcus MD, Grilo CM. Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study. J Clin Psychiatry. 2010;71:175–184. doi: 10.4088/JCP.08m04328blu.
    1. de Zwaan M, Enderle J, Wagner S, Mühlhans B, Ditzen B, Gefeller O, Mitchell JE, Müller A. Anxiety and depression in bariatric surgery patients: A prospective, follow-up study using structured clinical interviews. J Affect Disord. 2011;133:61–68. doi: 10.1016/j.jad.2011.03.025.
    1. Zimmerman M. Diagnosing personality disorders: A review of issues and research models. Arc Genl Psychiatry. 1994;51:225–245.
    1. Luppino F, De Wit L, Bouvy P, Stijnen T, Cuijpers P, Penninx B, Zitman F. Overweight, Obesity, and Depression. Arch Gen Psychiatry. 2010;67:220–229. doi: 10.1001/archgenpsychiatry.2010.2.
    1. American Psychiatric Assosiation. Diagnostic and Statisitical Manual of Mental Disorders. 4. Washington, DC, American Psychiatric Assosiation; 1994. Text Revision.
    1. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59:34–57.
    1. Lecrubier Y, Sheehan D, Weiller E, Amorim P, Bonora I, Sheehan K, Janavs J, Dunbar G. The MINI International Neuropsychiatric Interview (M.I.N.I.) A Short Diagnostic Structured Interview: Reliability and Validity According to the CIDI. Eur Psychiatry. 1997;12:224–231. doi: 10.1016/S0924-9338(97)83296-8.
    1. First MB, Gibbon M, Spitzer RL, Williams JBW, Benjamin LS. Structured Clinical Interview for DSM-IV Axis II Personality. Washington, DC, American Psychiatric Press; 1997.
    1. First MB, Gibbon M, Spitzer RL, Williams JBW, Benjamin LS. User's guide for the structured clinical interview for DSM-IV Axis II personality disorders [SCID-II] Washington, DC, American Psychiatric Press; 1997.
    1. Ware JESK, Kosinski M. Health Survey Manual and Interpretion Guide. QualityMetric Inc; 2000.
    1. Loge JH, Kaasa S. Short form 36 (SF-36) health survey: normative data from the general Norwegian population. Scandinavian Journal of Social Medicine. 1998;26(4):250–258.
    1. Hjermstad MJ, Fayers PM, Bjordal K, Kaasa S. Using reference data on quality of life--the importance of adjusting for age and gender, exemplified by the EORTC QLQ-C30 (+3) Eur J Cancer. 1998;34(9):1381–1389. doi: 10.1016/S0959-8049(98)00136-1.
    1. Cohen J. Statistical power analysis for the behavioral sciences. New York: New York: Academic; 1978.
    1. Altman DG. Practical statistics for medical research. Chapman & Hall/CRC; 1991.
    1. Cohen J. Statistical power analysis for the behavioral sciences. Lawrence Erlbaum; 1988.
    1. Lier HO, Biringer E, Stubhaug B, Eriksen HR, Tangen T. Psychiatric disorders and participation in pre- and postoperative counselling groups in bariatric surgery patients. Obes Surg. 2011;21:730–737. doi: 10.1007/s11695-010-0146-7.
    1. Andersen JR, Aasprang A, Bergsholm P, Sletteskog N, Vage V, Natvig GK. Predictors for health-related quality of life in patients accepted for bariatric surgery. Surg Obes Relat Dis. 2009;5:329–333. doi: 10.1016/j.soard.2008.11.012.
    1. Tillfors M, Ekselius L. Social phobia and avoidant personality disorder: are they separate diagnostic entities or do they reflect a spectrum of social anxiety? Isr J Psychiatry Relat Sci. 2009;46:25–33.
    1. Liebowitz MR, Schneier F, Campeas R, Hollander E, Hatterer J, Fyer A, Gorman J, Papp L, Davies S, Gully R. Phenelzine vs atenolol in social phobia. A placebo-controlled comparison. Arch Gen Psychiatry. 1992;49:290–300.
    1. Sarwer DB, Wadden TA, Moore RH, Eisenberg MH, Raper SE, Williams NN. Changes in quality of life and body image after gastric bypass surgery. Surg Obes Relat Dis. pp. 608–614.
    1. Simon GE, Arterburn DE. Does comorbid psychiatric disorder argue for or against surgical treatment of obesity? Gen Hosp Psychiatry. 2009;31:401–402. doi: 10.1016/j.genhosppsych.2009.05.014.
    1. Schowalter M, Benecke A, Lager C, Heimbucher J, Bueter M, Thalheimer A, Fein M, Richard M, Faller H. Changes in depression following gastric banding: a 5- to 7-year prospective study. Obes Surg. 2008;18:314–320. doi: 10.1007/s11695-007-9316-7.
    1. Brancatisano A, Wahlroos S, Brancatisano R. Improvement in comorbid illness after placement of the Swedish Adjustable Gastric Band. Surg Obes Relat Dis. 2008;4:S39–46. doi: 10.1016/j.soard.2008.04.006.
    1. Mitchell JE, Lancaster KL, Burgard MA, Howell LM, Krahn DD, Crosby RD, Wonderlich SA, Gosnell BA. Long-term follow up of patients' status after gastric bypass. Obes Surg. 2001;11:464–468. doi: 10.1381/096089201321209341.

Source: PubMed

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