This study aims to review the obesity literature in order to assess the impact of bariatric surgery on quality of life and the between-study variation by examining the standardized mean magnitude of effect in change in the levels of quality of life. The following databases EMBASE, PubMed, PsycINFO, CINAHL, the Cochrane Library and Web of Science were systematically searched for studies examining change in quality of life in adults receiving bariatric surgery for obesity. Seventy-two studies were included with a total of 9,433 participants treated for obesity with bariatric surgery. The average impact of bariatric surgery on quality of life corresponded to an effect size of 0.88 (95% CI: 0.80-0.96), indicating that bariatric surgery has a significant positive influence on quality of life in general. The impact varied considerably across studies with bariatric surgery showing a significantly greater positive influence on physical quality of life compared to mental quality of life. Bariatric surgery is effective in improving quality of life, especially when looking at physical well-being. Greater focus on the psychological well-being of the person undergoing surgery for obesity may lead to a better post-surgery prognosis for more people.

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Psychiatric disorders as risk factors for type 2 diabetes: an umbrella review of systematic reviews with and without meta-analyses,

Aims/hypothesis Estimates of the global prevalence of type 2 diabetes vary between 6% and 9%. The prevalence of type 2 diabetes has also been investigated in psychiatric populations, but a critical appraisal of the existing evidence is lacking, and an overview is needed. This umbrella review summarizes existing systematic reviews of observational studies investigating the prevalence of type 2 diabetes in people with a psychiatric disorder. MethodsWe searched PubMed, EMBASE, PsycINFO and Cochrane Database of Systematic Reviews from inception to January 17, 2021, and screened reference lists of included systematic reviews. Based on prespecified criteria we included systematic reviews investigating prevalence of type 2 diabetes in adults (≥18years) with a psychiatric disorder. Title and abstracts of 5,155 identified records and full text of 431 selected studies were screened by two independent reviewers, based on predefined eligibility criteria and an a priori developed extraction form, following the PRISMA and MOOSE guidelines. Risk of bias was assessed with the ROBIS instrument. Data extracted from primary studies were synthesized using random-effects metaanalyses.Results A total of 32 systematic reviews with 245 unique primary studies were identified and met inclusion criteria. Of them, 12 had low risk of bias. They reported type 2 diabetes prevalence estimates ranging from 5% to 22% depending on the specific psychiatric disorder. We meta-analyzed data for ten categories of psychiatric disorders and found prevalence estimates of type 2 diabetes varying between 8% to 40%: 40% among people with sleep disorders, 21% in binge eating disorders, 16% in substance use disorders, 14% in anxiety disorders, 11% in bipolar disorders, 11% in psychosis, 10% in schizophrenia, 10% in a mixed group of psychiatric disorders, 9% in depression, and 8% in intellectual disabilities. All meta-analyses revealed high levels of heterogeneity. Conclusions/interpretationType 2 diabetes is a common comorbidity in people with a psychiatric disorder.Future research should investigate whether routine screening for type 2 diabetes and subsequent prevention initiatives for these people are warranted. PROSPERO registration no: CRD42020159870How might this impact on clinical practice in the foreseeable future?• Type 2 diabetes is a common comorbidity in individuals with psychiatric disorders. Future research should evaluate whether diabetes screening is warranted and whether diabetes treatment targets are currently met in this group.

Individuals with a binge/purge-type of eating disorder may be particularly vulnerable to interpersonal issues and these issues may lead to poorer treatment recovery by reducing the individual's ability to engage in the treatment process on a functional level. The clinical and research implications are discussed.

Context Persons with severe mental illness (SMI) are at increased risk to develop type 2 diabetes. Objective It is unclear whether persons with diabetes and SMI are also at increased risk of diabetes complications and the potential age-specific differences in development of these. Design, setting, and participants Utilizing nationwide register data we followed the entire Danish population with type 2 diabetes from 01.01.1996 to 31.12.2018. Exposure was SMI (schizophrenia, bipolar or depression disorders). Outcome was diabetes complications (nephropathy, retinopathy, lower limp amputations, and cardiovascular disease). We applied Poisson regression models to estimate overall incidence rate ratios (IRRs) and age-specific incidence rates (IRs) and IRRs of first event of each complication in persons with SMI compared to persons without SMI. The models were adjusted for sex, age, diabetes duration, calendar year, education, and migration status. Results We followed 371,625 persons with type 2 diabetes, of which 30,102 had coexisting diagnosed SMI. Persons with SMI had a higher IR of nephropathy (IRR: 1.15; 95% CI: 1.12-1.18), amputations (IRR: 1.15; 95% CI: 1.04-1.28), and cardiovascular disease (men: IRR: 1.10; 95% CI: 1.06-1.15, women: IRR: 1.18; 95% CI: 1.13-1.22) but a lower IR of retinopathy (IRR: 0.75; 95% CI: 0.70-0.81) when compared to persons without SMI, after adjustment for confounders. For all complications except amputations, the difference in IR was highest in the younger age groups. Conclusions Persons with type 2 diabetes and SMI had a higher risk and an earlier onset of several diabetes complications diagnosis, emphasizing focusing on improving diabetes management in younger age groups with SMI.

OBJECTIVE Previous studies have investigated the incidence of type 2 diabetes in individuals with psychiatric disorders, but most studies have focused on a specific psychiatric disorder or a selected sample. More population-based studies are needed to determine these associations in representative samples. We therefore aimed to determine these associations in a nationwide, register-based dynamic cohort study. RESEARCH DESIGN AND METHODS We analyzed data from 5,005,612 adults living in Denmark between 1995 and 2018, without prior diabetes. We investigated 10 different categories of psychiatric disorders and a composite group with any psychiatric disorder. Individuals with a psychiatric disorder were compared with individuals without using multivariable-adjusted Poisson regression to estimate incidence rate ratios (IRR) of type 2 diabetes. We modeled age-specific incidence rates (IR) for individuals with and without the specific psychiatric disorder. All models were stratified by sex. RESULTS In total, 334,739 individuals developed type 2 diabetes during follow-up. For all investigated categories of psychiatric disorders, we found increased IR of type 2 diabetes for individuals with versus those without a psychiatric disorder (IRR: men, 1.47 [95% CI 1.45–1.50]; women, 1.65 [95% CI 1.62–1.68]). When we examined age-specific IR, the largest differences were found in the younger population (<50 years). CONCLUSIONS We found that the IR of type 2 diabetes was higher in individuals with a psychiatric disorder compared with individuals without a psychiatric disorder and particularly high in the younger people with a psychiatric disorder. New studies into the prevention and early detection of type 2 diabetes in these groups are warranted.

OBJECTIVE In this study, we aimed to explore interactions between individual items that assess diabetes distress, depressive symptoms, and anxiety symptoms in a cohort of adults with type 2 diabetes using network analysis. RESEARCH DESIGN AND METHODS Participants (N = 1,796) were from the Montreal Evaluation of Diabetes Treatment (EDIT) study from Quebec, Canada. A network of diabetes distress was estimated using the 17 items of the Diabetes Distress Scale (DDS-17). A second network was estimated using the DDS-17 items, the nine items of the Patient Health Questionnaire (PHQ-9), and the seven items of the Generalized Anxiety Disorder Assessment (GAD-7). Network analysis was used to identify central items, clusters of items, and items that may act as bridges between diabetes distress, depressive symptoms, and anxiety symptoms. RESULTS Regimen-related and physician-related problems were among the most central (highly connected) and influential (most positive connections) in the diabetes distress network. The depressive symptom of failure was found to be a potential bridge between depression and diabetes distress, being highly connected to diabetes distress items. The anxiety symptoms of worrying too much, uncontrollable worry, and trouble relaxing were identified as bridges linking both anxiety and depressive items and anxiety and diabetes distress items, respectively. CONCLUSIONS Regimen-related and physician-related diabetes-specific problems may be important in contributing to the development and maintenance of diabetes distress. Feelings of failure and worry are potentially strong candidates for explaining comorbidity. These individual diabetes-specific problems and mental health symptoms could hold promise for targeted interventions for people with type 2 diabetes.