目的:减肥手术是治疗严重肥胖的有效方法,可显著改善身体健康。很少有研究使用标准化的病例发现措施对焦虑或抑郁症进行前瞻性描述手术对心理健康的短期影响。这项研究描述了手术后这些疾病的患病率和短期过程。
方法:前瞻性观察性队列研究。
方法:英格兰的12个国家卫生服务中心。
方法:研究参与者参加了By-Band-Sleeve研究,一项多中心随机对照试验,评估重度肥胖的外科治疗.我们包括接受手术的参与者(胃旁路,胃束带或袖状胃切除术)随机分组后6个月内。
方法:在基线和随机化后12个月使用医院焦虑和抑郁量表(HADS)评估焦虑和抑郁。随机分组前收集的社会人口统计学变量包括体重指数,年龄,性别,种族,婚姻状况,烟草使用,就业状况和收入区间。
结果:在我们的758名参与者的样本中,94.5%(n716)和93.9%(n712)完成基线焦虑(HADS-A)和抑郁(HADS-D)分量表。在随机分组前,46.1%(n330/716,95%CI42.4%至49.7%)符合焦虑的临床病例标准,48.2%(n343/712,95%CI44.5%至51.8%)符合抑郁的临床病例标准。在完成随机化后12个月问卷的参与者中(HADS-An503/716,HADS-Dn498/712),焦虑的临床病例比例显着降低(-9.5%,95%CI-14.3%至-4.8%p<0.001)和抑郁(-22.3%,95%CI-27.0%至-17.6%p<0.001)。
结论:接受减肥手术的患者中几乎有一半有潜在的焦虑或抑郁症状。在短期内,这些症状似乎大大改善。未来的工作必须确定这些影响是否持续到随机化后的第一个年份。
背景:NCT02841527和ISRCTN00786323。
Bariatric surgery is an effective treatment for severe obesity that leads to significant physical health improvements. Few studies have prospectively described the short-term impact of surgery on mental health using standardised case-finding measures for anxiety or depressive disorders. This study describes the prevalence and short-term course of these conditions following surgery.
Prospective observational cohort study.
12 National Health Service centres in England.
Participants studied took part in the By-Band-Sleeve study, a multicentre randomised controlled trial evaluating the surgical management of severe obesity. We included participants who had undergone surgery (gastric bypass, gastric band or sleeve gastrectomy) within 6 months of randomisation.
Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) at baseline and 12 months post-randomisation. Sociodemographic variables collected at prerandomisation included body mass index, age, sex, ethnicity, marital status, tobacco use, employment status and income band.
In our sample of 758 participants, 94.5% (n 716) and 93.9% (n 712) had completed baseline anxiety (HADS-A) and depression (HADS-D) subscales. At pre-randomisation 46.1% (n 330/716, 95% CI 42.4% to 49.7%) met clinical case criteria for anxiety and 48.2% (n 343/712, 95% CI 44.5% to 51.8%) for depression. Among participants returning completed 12 months post-randomisation questionnaires (HADS-A n 503/716, HADS-D n 498/712), there was a significant reduction in the proportion of clinical cases with anxiety (-9.5%, 95% CI -14.3% to -4.8% p<0.001) and depression (-22.3%, 95% CI -27.0% to -17.6% p<0.001).
Almost half of people undergoing bariatric surgery had underlying anxiety or depressive symptoms. In the short term, these symptoms appear to substantially improve. Future work must identify whether these effects are sustained beyond the first post-randomisation year.
NCT02841527 and ISRCTN00786323.