Assessment of depressive symptoms, self-esteem, and eating psychopathology after laparoscopic sleeve gastrectomy: 1-year

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ORIGINAL ARTICLE

Assessment of depressive symptoms, self‑esteem, and eating psychopathology after laparoscopic sleeve gastrectomy: 1‑year follow‑up and comparison with healthy controls Saliha Çalışır1 · Akın Çalışır2 · Mehmet Arslan3   · İkbal İnanlı1 · Ali Metehan Çalışkan1 · İbrahim Eren1 Received: 8 June 2019 / Accepted: 21 September 2019 © Springer Nature Switzerland AG 2019

Abstract Purpose  The aim of this study was to assess depressive symptoms, self-esteem, and eating psychopathology in bariatric surgery patients at the preoperative period (t0) and at the 6-month (t1) and 12-month (t2) follow-ups after laparoscopic sleeve gastrectomy (LSG). A second aim was to investigate associations between these variables and weight loss. Method  The study participants were 48 bariatric surgery candidates and 50 non-obese controls. Both groups underwent assessment with the Sociodemographic Data Form, Hamilton Depression Rating Scale (HDRS), Eating Disorder Examination Questionnaire (EDE-Q), and Rosenberg Self-esteem Scale (RSES). These assessments were repeated for the patient group at t1 and t2. Results  The HDRS, RSES, and EDE-Q scores were higher in the patients before LSG (t0) than in the control group. A significant progressive improvement was identified in the patient HDRS and RSES scores as well as EDE-Q weight and shape subscale scores at t1 and t2. However, the patient EDE-Q total and dietary restraint scores improved at t1 then stabilized. The patient EDE-Q eating concern subscale improved at t1, but then worsened. The patient HDRS scores at t2 were similar to the control group, but the EDE-Q and RSES scores were still higher than the control scores at t2. Regression analyses revealed no association between the preoperative scores and percent changes in postoperative scores for any scale and patient weight loss at t2. Conclusion  Depressive symptoms, self-esteem, and eating psychopathology showed an improving trend in patients after LSG. However, some aspects of eating psychopathology worsened despite an initial improvement. Level of evidence  III, prospective cohort and case–control study. Keywords  Obesity · Laparoscopic sleeve gastrectomy · Weight loss · Depression · Eating disorder · Self-esteem

Introduction Obesity is a rising public health problem worldwide that is related to increased morbidity and mortality [1]. Bariatric surgery is one of the most effective treatment methods for significant and sustainable weight loss in severe obesity [2]. * Mehmet Arslan [email protected] 1



Department of Psychiatry, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey

2



Department of General Surgery, Selcuk University Faculty of Medicine, Konya, Turkey

3

Department of Psychiatry, Babaeski State Hospital, 39200 Kırklareli, Turkey



Individuals with morbid obesity also have a high rate of psychiatric disorder comorbidity in addition to their metabolic co-morbidities. Approximately 66% of bariatric surgery patients have a lifetime history of one or more Axis I psych