The Emergence of Depression and Anxiety Disorder in a Patient Following Bariatric Surgery: A Case Report

Öz

Psychiatric comorbidities are commonly encountered in obese patients admitted for bariatric surgery among which major depressive disorder and anxiety disorder are the most common types. Although most studies demonstrate a significant reduction in psychiatric complaints at postoperative follow-up, the relationship or mechanism of such effect is not definitive. We report the emergence of major depressive disorder and anxiety disorder in a 57-year old female patient at sixth-month follow-up with no family history of psychiatric disorder or preoperative psychiatric disorder. Symptomatic control has been achieved with selective serotonin reuptake inhibitor therapy. Hereby, we recommend close psychiatric follow-up of bariatric surgery candidates at pre and postoperative periods.

Anahtar Kelimeler

• Bariatric surgeries
• major depressive disorder
• anxiety disorders

Bariatrik Cerrahi Sonrası Major Depresyon ve Anksiyete Bozukluğu Gelişimi: Bir Vaka Sunumu

Öz

Bariyatrik ameliyat için hastaneye başvuran obez hastalarda majör depresyon ve anksiyete bozuklukları başta olmak üzere psikiyatrik hastalıklar sıklıkla görülmektedir. Ameliyat sonrası dönemde psikiyatrik belirtilerde gerileme çok sayıda çalışmada bildirilmiş olmasına rağmen olası ilişkinin mekanizması net değildir. Bu vaka sunumunda ameliyat öncesindeki psikiyatrik değerlendirmesinde herhangi bir psikiyatrik hastalığı veya psikiyatrik hastalıklar açısından aile hikayesi olmayan 57 yaşında bir kadın hastada ameliyat sonrası dönemde major depresyon ve anksiyete bozukluğu gelişimini göstermekteyiz. Hastada seçici serotonin geri alım inhibitörü tedavisiyle semptomatik kontrol sağlanmıştır. Bu bağlamda, bariatrik cerrahi adayı hastaların ameliyat öncesi ve sonrası dönemde yakın psikiyatrik takibi yapılması gerektiğini önermekteyiz.

Anahtar Kelimeler

• Bariyatrik cerrahiler
• major depresif bozukluk
• anksiyete bozuklukları

Kaynakça

1. Burgmer, R., Petersen, I., Burgmer, M., de Zwaan, M., Wolf, A. M., & Herpertz, S. (2007). Psychological outcome two years after restrictive bariatric surgery. Obesity surgery, 17(6), 785-791.
2. de Zwaan, M., Enderle, J., Wagner, S., Mühlhans, B., Ditzen, B., Gefeller, O., . . . Müller, A. (2011). Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. Journal of affective disorders, 133(1-2), 61-68.
3. Dimitriadis, G. K., Randeva, M. S., & Miras, A. D. (2017). Potential hormone mechanisms of bariatric surgery. Current obesity reports, 6(3), 253-265.
4. Faria, S., Faria, O., Cardeal, M., de Novaes, M., Marques, J., & Feitosa, I. (2016). Association between depression and nutritional deficiencies among Roux-en-Y Gastric Bypass patients. Surgery for Obesity and Related Diseases, 12(7), S175-S176.
5. Fisher, D., Coleman, K. J., Arterburn, D. E., Fischer, H., Yamamoto, A., Young, D. R., . . . Lewis, K. H. (2017). Mental illness in bariatric surgery: A cohort study from the PORTAL network. Obesity, 25(5), 850-856.
6. Gibb, J., Rogers, C., Gidman, E., Mazza, G., Blazeby, J., & Moran, P. (2021). Prevalence and course of anxiety and depression among patients selected for bariatric surgery. BJPsych Open, 7(S1), S25-S25.
7. Gill, H., Kang, S., Lee, Y., Rosenblat, J. D., Brietzke, E., Zuckerman, H., & McIntyre, R. S. (2019). The long-term effect of bariatric surgery on depression and anxiety. Journal of affective disorders, 246, 886-894.
8. Himel, A. R., Cabral, S. A., Shaffery, J. P., & Grayson, B. E. (2018). Anxiety behavior and hypothalamic-pituitary-adrenal axis altered in a female rat model of vertical sleeve gastrectomy. PloS one, 13(7).

9. Lagerros, Y. T., Brandt, L., Hedberg, J., Sundbom, M., & Bodén, R. (2017). Suicide, Self-harm, and depression after gastric bypass surgery. Annals of surgery, 265(2), 235-243.
10. Luppino, F. S., de Wit, L. M., Bouvy, P. F., Stijnen, T., Cuijpers, P., Penninx, B. W., & Zitman, F. G. (2010). Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Archives of general psychiatry, 67(3), 220-229.
11. Mitchell, J. E., King, W. C., Chen, J. Y., Devlin, M. J., Flum, D., Garcia, L., . . . Khandelwal, S. (2014). Course of depressive symptoms and treatment in the longitudinal assessment of bariatric surgery (LABS‐2) study. Obesity, 22(8), 1799-1806.
12. Sarwer, D. B., Cohn, N. I., Gibbons, L. M., Magee, L., Crerand, C. E., Raper, S. E., . . . Wadden, T. A. (2004). Psychiatric diagnoses and psychiatric treatment among bariatric surgery candidates. Obesity surgery, 14(9), 1148-1156.
13. Sevinçer, G. M., Coşkun, H., Konuk, N., & Bozkurt, S. (2014). Bariatrik cerrahinin psikiyatrik ve psikososyal yönleri. Psikiyatride güncel yaklaşımlar, 6(1), 32-44.
14. Yuan, W., Yu, K. H., Palmer, N., Stanford, F. C., & Kohane, I. (2019). Evaluation of the association of bariatric surgery with subsequent depression. International Journal of Obesity, 43(12), 2528-2535.