title: [Influence of previous psychiatric disorders on postoperative course in patients undergoing bariatric surgery].
abstract: BACKGROUND
  Presurgical evaluation of patients undergoing bariatric surgery includes, among others, a psychological/psychiatric evaluation. Psychiatric disorders that did not contraindicate surgery may persist and influence on weight loss and postoperative clinical course, hindering the success of the procedure. The aim of our study was to analyze the postoperative evolution of our series of patients with and without psychiatric symptoms before surgery.
  
  
  METHODS
  Retrospective analysis of 109 patients undergoing bariatric surgery with duodenal switch from 2003 to 2008 (follow up > 6 months). We studied weight changes, immediate and delayed complications of surgery and nutritional deficiencies in post-surgical follow-up in patients with previous psychiatric disorders (group 1, n = 17) compared with patients without psychiatric disorders (group 2, n = 92).
  
  
  RESULTS
  Patients in group 1 showed a greater tendency for weight gain. They regained a 9.4% of the initial excess weight lost between 18 months after surgery and 36 months after surgery, while patients in group 2 regained only 0.2% in the same period (p < 0.05). There was no difference in immediate surgical complications (5/17 vs 25/92 patients). The mean incidence of late surgical complications was 0.71 per patient in group 1 and 0.22 complications per patient in group 2 (p = 0.02). 52.9% of patients in group 1 had at least one late complication compared to 19.6% of patients in group 2 (p = 0.003). The three most common complications in patients with previous psychiatric disorders were chronic diarrhea, vomits and malnutrition. The presence of nutritional deficiencies were common in both groups, mainly soluble vitamins, iron and zinc. During postoperative follow-up, we found 3.1 +/- 1.6 nutritional deficiencies per patient in group 1 and 2.5 +/- 1.7 in group 2 (p = 0.04). More than three nutritional deficiencies were found in 8 patients in group 1 (52.9%) compared to 23 patients in group 2 (25%) (p = 0.03).
  
  
  CONCLUSIONS
  The presence of previous psychiatric disorders may be a predictor of a less positive outcome in morbidly obese patients who undergo bariatric surgery.
authors.affiliation: Sección de Endocrinología y Nutrición, Complejo Hospitalario Universitario de Albacete, Albacete, España. fbotellar@sescam.jccm.es
authors.forename: Francisco
authors.initials: F
authors.lastname: Botella Romero
authors.forename: José Joaquín
authors.initials: JJ
authors.lastname: Alfaro Martínez
authors.forename: Elena
authors.initials: E
authors.lastname: Molina Pacheco
authors.forename: Amparo
authors.initials: A
authors.lastname: Lomas Meneses
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Salas Saiz
authors.forename: Angélica
authors.initials: A
authors.lastname: García Gómez
authors.forename: Llanos
authors.initials: L
authors.lastname: García Arce
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome