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01-01-2016

Patients with psychiatric comorbidity can safely undergo bariatric surgery with equivalent success

Authors: Hans F. Fuchs, Vanessa Laughter, Cristina R. Harnsberger, Ryan C. Broderick, Martin Berducci, Christopher DuCoin, Joshua Langert, Bryan J. Sandler, Garth R. Jacobsen, William Perry, Santiago Horgan

Published in: Surgical Endoscopy | Issue 1/2016

Abstract

Introduction

Patients with psychiatric disorder were reported to have a poor outcome in bariatric surgery. Few studies have examined the outcome of laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) in patients with psychiatric history. We aimed to compare excess weight loss (%EWL) in patients with and without psychiatric comorbidities who underwent LSG or LAGB.

Methods

Patients undergoing LSG or LAGB were identified from our prospective database. A multidisciplinary team evaluated all patients preoperatively, including a psychological evaluation. Patients with the diagnosis of depression, anxiety, bipolar disorder, and schizophrenia were included in the psychiatric comorbidity group (PSY). Others were included in group NON-PSY. All patients were first screened to be psychologically stable to undergo surgery. Initial BMI and %EWL at 3, 6, and 12 months postoperatively were compared.

Results

A total of 590 patients (81.4 % women), with a median BMI of 43.8 kg/m² (range 30–99) who underwent LSG (n = 222) or LAGB (n = 368) from January 2006 to June 2013, were identified. Psychiatric comorbidities that were well controlled at the time of surgery were found in 188 patients (31.9 %). Diagnostic criteria for depression were met in 154 patients (26.1 %), 75 patients suffered from anxiety (12.7 %), 9 from bipolar disorder, and 4 from schizophrenia (0.7 %). Initial BMI was not different between the two groups. No significant difference in %EWL between the groups was found during follow-up (44.13 vs. 43.37 %EWL, respectively, at 1 year; p = 0.76). When LSG and LAGB patients were analyzed as subsets, again no difference in %EWL at 1 year was found for PSY vs. NON-PSY (LSG: 51.56 vs. 54.86 %EWL; LAGB: 38.48 vs. 38.45 %EWL, all p = ns). In multivariate analysis, the differences from unadjusted analysis persisted.

Conclusion

These findings demonstrate that a similar %EWL can be achieved in patients undergoing LSG or LAGB despite the presence of well-controlled psychiatric comorbidity.

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Title: Patients with psychiatric comorbidity can safely undergo bariatric surgery with equivalent success
Authors: Hans F. Fuchs
Vanessa Laughter
Cristina R. Harnsberger
Ryan C. Broderick
Martin Berducci
Christopher DuCoin
Joshua Langert
Bryan J. Sandler
Garth R. Jacobsen
William Perry
Santiago Horgan
Publication date: 01-01-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 1/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4196-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Patients with psychiatric comorbidity can safely undergo bariatric surgery with equivalent success

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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