Associations between perceived somatic symptoms and mental health after Roux-en-Y gastric bypass: a 3-year prospective cohort study

Abstract

BackgroundPreoperative anxiety, and to some extent depression, predict the perceived impact of somatic symptoms (such as dumping, pain, and fatigue) one year after Roux-en-Y gastric bypass (RYGB). Negative attention to and interpretation of somatic symptoms may thus be associated with post-operative changes in affect. ObjectivesThe aim of this study was to explore whether preoperative anxiety and depressive symptoms predicted the perceived impact of somatic symptoms three years after RYGB.Secondly, we aimed to examine the three-year trajectory of depressive and anxiety symptoms, and their interaction with perceived somatic symptoms postoperatively. SettingUniversity hospital. MethodsPre-surgery, 1-, and 3-years post-surgery data were collected from 169 participants (62.4% follow-up). A cross-lagged, autoregressive regression analysis was employed to examine the mutual interaction of trajectories over the follow-up period. ResultsFatigue (30.8%) and dumping (23.7%) were common high-impact symptoms three years postoperatively. Pre-surgery anxiety was associated with higher impact of fatigue (p<.001), pain (p<.001), and diarrhea (p<.001), while pre-surgery depressive mood was related to reporting higher impact of diarrhea (p<.01) at 3-year follow-up. Higher anxiety/depression symptoms were related to higher perceived total symptom impact at one and three years postoperatively, controlling for percent total weight loss. Higher impact of somatic symptoms at one-year post-surgery predicted a significant increase in depressive symptoms 3-years postsurgery. ConclusionHigher perceived total symptom burden (pain, fatigue, dumping, diarrhea, and vomiting) at one-year post-surgery predicted increase in depression over the next two years. The results underscore the importance of managing somatic symptoms after surgery to prevent patients' distress..

Predicting satisfaction with outcome and follow‐up care 5 years after bariatric surgery: A prospective evaluation

“… 23 , 24 For example, depressive symptoms have been associated with less outcome satisfaction at 2 years 12 and 4 years after surgery, 6 and body dissatisfaction has generally been related to lower satisfaction when assessed at the same time. 6 , 13 As post‐surgical psychological factors are often interrelated with both weight loss and negative somatic symptoms, 25 , 26 it can be challenging to dissect the specific impact of mental health and body image on the degree of satisfaction with the outcome.…”

Abdominal pain: A foe in the orchestra of improving symptoms after Roux‐en‐Y gastric bypass surgery

“…1,6,7 Somatic symptoms after RYGB has also been associated with an increased risk of depression. 14 The impact of these symptoms varies and interestingly, in a large series, although reporting high rates of various symptoms, 87.4% (1219 patients) felt better or much better 4.7 years after RYGB. 1 However, a high number of symptoms was associated with less well-being.…”

“…1,5,6 Preoperative anxiety has been associated with higher impact of somatic symptoms after RYGB. 14 Symptoms prior to RYGB appears to be a risk factor in several series.…”

“…Risk factors for postoperative abdominal pain varies across series and include female gender, young age, smoking, symptoms prior to surgery, preoperative use of strong analgesics, complications to surgery, and unemployment 1,5,6 . Preoperative anxiety has been associated with higher impact of somatic symptoms after RYGB 14 . Symptoms prior to RYGB appears to be a risk factor in several series.…”

“…Abdominal pain post bariatric surgery may affect sleep and daily life activities and reduce quality of life 1,6,7 . Somatic symptoms after RYGB has also been associated with an increased risk of depression 14 . The impact of these symptoms varies and interestingly, in a large series, although reporting high rates of various symptoms, 87.4% (1219 patients) felt better or much better 4.7 years after RYGB 1 .…”