title: Prognostic Significance of Depressive Symptoms on Weight Loss and Psychosocial Outcomes Following Gastric Bypass Surgery: A Prospective 24-Month Follow-Up Study.
abstract: BACKGROUND
  This study examined the prognostic significance of depressive symptoms in bariatric surgery patients over 24 months of follow-ups.
  
  
  METHODS
  Three hundred fifty-seven patients completed a battery of assessments before and at 6, 12, and 24 months following gastric bypass surgery. In addition to weight loss and depressive symptoms, the assessments targeted eating disorder psychopathology and quality of life.
  
  
  RESULTS
  Clinically significant depressive symptoms, defined as a score of 15 or greater on the Beck Depression Inventory, characterized 45% of patients prior to surgery, and 12% at 6-month follow-up, 13% at 12-month follow-up, and 18% at 24-month follow-up. Preoperative depressive symptoms did not predict postoperative weight outcomes. In contrast, postsurgery depressive symptoms were predictive of weight loss outcomes. Higher postsurgery depressive symptoms at each time point predicted a greater degree of concurrent and subsequent eating disorder psychopathology and lower quality of life.
  
  
  CONCLUSIONS
  The frequency of elevated depressive symptoms decreases substantially following gastric bypass surgery but increases gradually over 24 months. Postoperative depressive symptoms are significantly associated with poorer weight outcomes at 6 and 12 months following surgery but do not predict longer-term weight outcomes at 24 months. Postoperative depressive symptoms prospectively predict greater eating disorder psychopathology and poorer quality of life through 24 months. Elevated depressive symptoms, readily assessed by self-report, may signal a need for clinical attention after surgery.
authors.affiliation: Program for Obesity Weight and Eating Research, Department of Psychiatry, Yale University School of Medicine, PO Box 208098, New Haven, CT, 06520, USA, Marney.white@yale.edu.
authors.forename: Marney A
authors.initials: MA
authors.lastname: White
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Kalarchian
authors.forename: Michele D
authors.initials: MD
authors.lastname: Levine
authors.forename: Robin M
authors.initials: RM
authors.lastname: Masheb
authors.forename: Marsha D
authors.initials: MD
authors.lastname: Marcus
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
mesh_terms: D000328:Adult; D003863:Depression; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D057566:Self Report; D015431:Weight Loss