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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2020; 14(04): 224-228
DOI: 10.1055/a-1241-7626
Review

Depression und Suizid/Suizidalität nach adipositaschirurgischen Eingriffen

Depression and Suicide/Suicidal Ideation after Bariatric Surgery
Martina de Zwaan
1   Klinik für Psychosomatik und Psychotherapie, Medizinische Hochschule, Hannover, Deutschland
,
Astrid Müller
1   Klinik für Psychosomatik und Psychotherapie, Medizinische Hochschule, Hannover, Deutschland
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Zusammenfassung

Ziel: Personen mit schwerer Adipositas profitieren von adipositaschirurgischen Maßnahmen bezüglich Gewichtsabnahme und Reduktion körperlicher Komorbiditäten. Der Artikel fokussiert auf postoperative Depression und Suizidalität/Suizid und stellt eine narrative Überblicksarbeit von rezenten Metaanalysen und kontrollierten Studien dar.

Methodik: Selektive Literatursuche.

Ergebnisse: Es gibt deutliche Hinweise auf eine kurz- bis mittelfristige Reduktion von depressiven Symptomen nach Adipositaschirurgie. Eine Subgruppe von Patienten zeigt längerfristig jedoch eine Wiederzunahme der depressiven Symptomatik oder das erstmalige Auftreten einer depressiven Symptomatik. Große Kohorten-Studien lassen ein erhöhtes Risiko für selbstschädigendes Verhalten und Suizid bei postoperativen Patienten vermuten.

Schlussfolgerungen: Prospektive longitudinale Studien, die das Zusammenspiel von Faktoren untersuchen, die zu Depression und Suizid nach Adipositaschirurgie beitragen, stehen noch aus. Die sowohl prä- als auch postoperativen multi-professionellen Teams sollten immer auch einen Experten für psychische Erkrankungen involvieren, um eine professionelle Diagnostik zu realisieren und Risikopatienten rechtzeitig identifizieren zu können.

Abstract

Purpose: Individuals with severe obesity benefit from bariatric surgery with respect to weight loss and decreases in somatic comorbidity. This paper focuses on postoperative depression and suicidality/suicide and provides a narrative review of recent meta-analyses and controlled studies.

Method: selective literature search.

Results: Considerable evidence shows short and medium-term reduction in depressive symptoms after surgery. However, a subgroup of patients exhibits erosion of these improvements or new onset of depression in the long run. Large cohort studies have found an increased risk for suicide among postoperative patients.

Conclusion: Prospective longitudinal examinations of factors contributing to the increased risk for postoperative depression and suicide and the interaction between these factors are warranted. The inclusion of mental health professionals in bariatric surgery teams would help to monitor patients and identify at-risk patients.

Schlüsselwörter

Adipositaschirurgie - Depression - Suizid - Suizidalität

Key words

Bariatric surgery - Depression - suicide - suicide ideation


Publication History

Article published online:
01 December 2020

© 2020. Thieme. All rights reserved.

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  • Literatur

  • 1 Risk Factor NCD. Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017; 390: 2627-2642
    CrossrefPubMedGoogle Scholar
  • 2 Di Angelantonio E, Bhupathiraju SN, Wormser D. et al. Body-mass index and all-cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet 2016; 388: 776-786
    CrossrefPubMedGoogle Scholar
  • 3 American Society for Metabolic and Bariatric Surgery. Estimate of Bariatric Surgery Numbers. 2011-2018 asmbs.org/resources/estimate-of-bariatric-surgery-numbers
  • 4 O’Brien PE, Hindle A, Brennan L. et al. Long-term outcomes after bariatric surgery: A systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg 2019; 29: 3-14
    CrossrefPubMedGoogle Scholar
  • 5 Khosravi-Largani M, Nojomi M, Aghili R. et al. Evaluation of all types of metabolic bariatric surgery and its consequences: A systematic review and meta-analysis. Obes Surg 2019; 29: 651-690
    CrossrefPubMedGoogle Scholar
  • 6 Arterburn DE, Olsen MK, Smith VA. et al. Association between bariatric surgery and long-term survival. JAMA 2015; 313: 62-70
    CrossrefPubMedGoogle Scholar
  • 7 Dawes AJ, Maggard-Gibbons M, Maher AR. et al. Mental health conditions among patients seeking and undergoing bariatric surgery: A meta-analysis. JAMA 2016; 315: 150-163
    CrossrefPubMedGoogle Scholar
  • 8 Mitchell JE, King WC, Chen JY. et al. Course of depressive symptoms and treatment in the longitudinal assessment of bariatric surgery (LABS-2) study. Obesity (Silver Spring) 1806; 2014 (22) : 1799
    PubMedGoogle Scholar
  • 9 Gill H, Kang S, Lee Y. et al. The long-term effect of bariatric surgery on depression and anxiety. J Affect Disord 2019; 246: 886-894
    CrossrefPubMedGoogle Scholar
  • 10 de Zwaan M, Enderle J, Wagner S. et al. Anxiety and depression in bariatric surgery patients: A prospective, follow-up study using structured clinical interviews. J Affect Disord 2011; 133: 61-68
    Google Scholar
  • 11 Karlsson J, Taft C, Ryden A. et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: The SOS intervention study. Int J Obes (Lond) 2007; 31: 1248-1261
    CrossrefPubMedGoogle Scholar
  • 12 Kalarchian MA, Marcus MD. Psychosocial concerns following bariatric surgery: Current status. Curr Obes Rep 2019; 8: 1-9
    CrossrefPubMedGoogle Scholar
  • 13 White MA, Kalarchian MA, Levine MD. et al. Prognostic significance of depressive symptoms on weight loss and psychosocial outcomes following gastric bypass surgery: A prospective 24-month follow-up study. Obes Surg 1916; 2015 (25) : 1909
    PubMedGoogle Scholar
  • 14 Sarwer DB, Allison KC, Wadden TA. et al. Psychopathology, disordered eating, and impulsivity as predictors of outcomes of bariatric surgery. Surg Obes Relat Dis 2019; 15: 650-655
    CrossrefPubMedGoogle Scholar
  • 15 Müller A, Hase C, Pommnitz M. et al. Depression and suicide after bariatric surgery. Curr Psychiatry Rep 2019; 21: 84
    CrossrefPubMedGoogle Scholar
  • 16 Lagerros YT, Brandt L, Hedberg J. et al. Suicide, self-harm, and depression after gastric bypass surgery: A nationwide cohort study. Ann Surg 2017; 265: 235-243
    CrossrefPubMedGoogle Scholar
  • 17 Peterhänsel C, Petroff D, Klinitzke G. et al. Risk of completed suicide after bariatric surgery: A systematic review. Obes Rev 2013; 14: 369-382
    CrossrefPubMedGoogle Scholar
  • 18 Mitchell JE, Crosby R, de Zwaan M. et al. Possible risk factors for increased suicide following bariatric surgery. Obesity (Silver Spring) 2013; 21: 665-672
    CrossrefPubMedGoogle Scholar
  • 19 Adams TD, Mehta TS, Davidson LE. et al. All-cause and cause-specific mortality associated with bariatric surgery: A review. Curr Atheroscler Rep 2015; 17: 74
    CrossrefPubMedGoogle Scholar
  • 20 Luppino FS, de Wit LM, Bouvy PF. et al. Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67: 220-229
    CrossrefPubMedGoogle Scholar
  • 21 Monpellier VM, Antoniou EE, Mulkens S. et al. Body image dissatisfaction and depression in postbariatric patients is associated with less weight loss and a desire for body contouring surgery. Surg Obes Relat Dis 2018; 14: 1507-1515
    CrossrefPubMedGoogle Scholar
  • 22 Coulman KD, MacKichan F, Blazeby JM. et al. Patient experiences of outcomes of bariatric surgery: A systematic review and qualitative synthesis. Obes Rev 2017; 18: 547-559
    CrossrefPubMedGoogle Scholar
  • 23 Spitznagel MB, Hawkins M, Alosco M. et al. Neurocognitive effects of obesity and bariatric surgery. Eur Eat Disord Rev 2015; 23: 488-495
    CrossrefPubMedGoogle Scholar
  • 24 Herpertz S, Müller A, Burgmer R. et al. Health-related quality of life and psychological functioning 9 years after restrictive surgical treatment for obesity. Surg Obes Relat Dis 2015; 11: 1361-1370
    CrossrefPubMedGoogle Scholar
  • 25 Lu CW, Chang YK, Lee YH. et al. Increased risk for major depressive disorder in severely obese patients after bariatric surgery - a 12-year nationwide cohort study. Ann Med 2018; 50: 605-612
    CrossrefPubMedGoogle Scholar
  • 26 Spirou D, Raman J, Smith E. Psychological outcomes following surgical and endoscopic bariatric procedures: A systematic review. Obes Rev 2020; 21: e12998
    CrossrefPubMedGoogle Scholar
  • 27 Morgan DJR, Ho KM, Platell C. Incidence and determinants of mental health service use after bariatric surgery. JAMA Psychiatry 2019; 77: 60-67
    CrossrefPubMedGoogle Scholar
  • 28 Tindle HA, Omalu B, Courcoulas A. et al. Risk of suicide after long-term follow-up from bariatric surgery. Am J Med 2010; 123: 1036-1042
    CrossrefPubMedGoogle Scholar
  • 29 Castaneda D, Popov VB, Wander P. et al. Risk of suicide and self-harm is increased after bariatric surgery - a systematic review and meta-analysis. Obes Surg 2019; 29: 322-333
    CrossrefPubMedGoogle Scholar
  • 30 Neovius M, Bruze G, Jacobson P. et al. Risk of suicide and non-fatal self-harm after bariatric surgery: Results from two matched cohort studies. Lancet Diabetes Endocrinol 2018; 6: 197-207
    CrossrefPubMedGoogle Scholar
  • 31 Sjöström L, Narbro K, Sjöström CD. et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 357: 741-752
    CrossrefPubMedGoogle Scholar
  • 32 Hedenbro JL, Näslund E, Boman L. et al. Formation of the Scandinavian Obesity Surgery Registry, SOReg. Obes Surg 1900; 2015 (25) : 1893
    PubMedGoogle Scholar
  • 33 Wnuk S, Parvez N, Hawa R. et al. Predictors of suicidal ideation one-year post-bariatric surgery: Results from the Toronto Bari-Psych Cohort Study. Gen Hosp Psychiatry 2020; 63: 39-45
    CrossrefPubMedGoogle Scholar
  • 34 Kauppila JH, Santoni G, Tao W. et al. Risk factors for suicide after bariatric surgery in a population-based nationwide study in five nordic countries. Ann Surg. 2020 Jul 9. doi: 10.1097/SLA.0000000000004232
    Google Scholar
  • 35 Roerig JL, Steffen KJ, Zimmerman C. et al. A comparison of duloxetine plasma levels in postbariatric surgery patients versus matched nonsurgical control subjects. J Clin Psychopharmacol 2013; 33: 479-484
    CrossrefPubMedGoogle Scholar
  • 36 Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie. S3-Leitlinie: Chirurgie der Adipositas und metabolischer Erkrankungen. Version 2.3 (Februar 2018) AWMF-Register Nr. 088–001.
    Google Scholar
  • 37 Stewart F, Avenell A. Behavioural interventions for severe obesity before and/or after bariatric surgery: A systematic review and meta-analysis. Obes Surg 2016; 26: 1203-1214
    CrossrefPubMedGoogle Scholar
  • 38 Hjelmesaeth J, Rosenvinge JH, Gade H. et al. Effects of cognitive behavioral therapy on eating behaviors, affective symptoms, and weight loss after bariatric surgery: A randomized clinical trial. Obes Surg 2019; 29: 61-69
    CrossrefPubMedGoogle Scholar
  • 39 Wild B, Hunnemeyer K, Sauer H. et al. A 1-year videoconferencing-based psychoeducational group intervention following bariatric surgery: Results of a randomized controlled study. Surg Obes Relat Dis 2015; 11: 1349-1360
    CrossrefPubMedGoogle Scholar