title: Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews.
abstract: BACKGROUND
  Candidates for bariatric surgery frequently have co-morbid psychiatric problems.
  
  
  METHODS
  This study investigated the course and the prognostic significance of preoperative and postoperative anxiety and depressive disorders in 107 extremely obese bariatric surgery patients in a prospective design with face-to-face interviews (SCID) conducted prior to the surgery and postoperatively after 6-12 months and 24-36 months.
  
  
  RESULTS
  The point prevalence of depressive disorders but not of anxiety disorders decreased significantly after surgery. Preoperative depressive disorders predicted depressive disorders 24-36 months but not 6-12 months after surgery, whereas preoperative anxiety significantly predicted postoperative anxiety disorders at both follow-up time points. Preoperative lifetime and current depressive disorders were unrelated to postoperative weight loss whereas preoperative lifetime, but not current anxiety disorders were of negative prognostic value for postoperative weight loss. Patients with both depressive and anxiety disorders at baseline (current and lifetime) lost significantly less weight after surgery. Postoperative anxiety disorder was not associated with the degree of weight loss at any follow-up time-point; however postoperative depressive disorder was negatively associated with weight loss at the 24-36 month follow-up assessment point.
  
  
  CONCLUSIONS
  Missing data, limited statistical power, self-reported height and weight are the limitations of this study.
  
  
  CONCLUSIONS
  As opposed to anxiety disorders, the point prevalence of depressive disorders decreased significantly after bariatric surgery. However, the presence of depressive disorders after bariatric surgery significantly predicted attenuated post-surgical improvements and may signal a need for clinical attention.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany. martina.dezwaan@uk-erlangen.de
authors.forename: Martina
authors.initials: M
authors.lastname: de Zwaan
authors.forename: Janna
authors.initials: J
authors.lastname: Enderle
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wagner
authors.forename: Barbara
authors.initials: B
authors.lastname: Mühlhans
authors.forename: Beate
authors.initials: B
authors.lastname: Ditzen
authors.forename: Olaf
authors.initials: O
authors.lastname: Gefeller
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: Astrid
authors.initials: A
authors.lastname: Müller
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety; D001008:Anxiety Disorders / Q000150:complications* / Q000453:epidemiology; D050110:Bariatric Surgery / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000601:surgery; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D011184:Postoperative Period; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D011613:Psychotherapy; D015431:Weight Loss