The Psychosocial Effects of Perioperative Complications After Bariatric Surgery

Karen Ho; Raed Hawa; Susan Wnuk; Allan Okrainec; Timothy Jackson; Sanjeev Sockalingam

doi:10.1016/j.psym.2018.03.005

The Psychosocial Effects of Perioperative Complications After Bariatric Surgery

Psychosomatics. 2018 Sep-Oct;59(5):452-463. doi: 10.1016/j.psym.2018.03.005. Epub 2018 Mar 21.

Authors

Karen Ho¹, Raed Hawa², Susan Wnuk³, Allan Okrainec⁴, Timothy Jackson⁴, Sanjeev Sockalingam⁵

Affiliations

¹ Faculty of Medicine, University of Toronto, Toronto, ON.
² Centre for Mental Health, University Health Network, Toronto, ON; Department of Psychiatry, University of Toronto, Toronto, ON; Toronto Western Hospital, Bariatric Surgery Program, Toronto, ON.
³ Department of Psychiatry, University of Toronto, Toronto, ON; Toronto Western Hospital, Bariatric Surgery Program, Toronto, ON.
⁴ Toronto Western Hospital, Bariatric Surgery Program, Toronto, ON; Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON.
⁵ Centre for Mental Health, University Health Network, Toronto, ON; Department of Psychiatry, University of Toronto, Toronto, ON; Toronto Western Hospital, Bariatric Surgery Program, Toronto, ON. Electronic address: sanjeev.sockalingam@uhn.ca.

PMID: 29699779
DOI: 10.1016/j.psym.2018.03.005

Abstract

Background: Bariatric surgery is an effective weight loss tool that results in sustained weight loss, improvement in obesity-related comorbidities, and positive psychosocial outcomes. However, bariatric procedures also present with risks, as surgical complications are not uncommon.

Objective: This study aims to better understand the effect of postoperative complications from bariatric surgeries on patients' psychosocial well-being.

Materials and methods: Surgical data on postoperative complications were matched with results from self-administered psychosocial questionnaires. Depression, anxiety, and quality of life (QOL) were assessed preoperatively, and at 1-year postoperatively.

Results: A total of 365 patients were included. Overall, the complication rate was 15.3% (n = 56), with 31 (8.5%) patients experiencing complications within 30 days of surgery, and 25 (6.8%) experiencing late complications. All patients achieved significant weight loss at 1-year postoperatively. Patients with uncomplicated recoveries showed significant improvement in depression (P < 0.001), anxiety (P < 0.001), mental QOL (P < 0.001), and physical QOL (P < 0.001) at 1-year postsurgery. Patients who experienced postoperative complications showed significant improvement in depression (P < 0.001), anxiety (P = 0.04) and physical QOL (P < 0.001), but not in mental QOL (P = 0.210). Despite improved psychosocial outcomes from baseline, patients experiencing complications showed higher postoperative depression scores (P < 0.01) and lower physical QOL (P < 0.01) than patients without complication. Comparison between those with early and late complications did not show significant difference in outcomes.

Conclusions: Complications following bariatric surgery can hinder improvements in patient's psychological well-being and QOL. Bariatric centers should provide more support for patients who have experienced complications.

Keywords: Anxiety; Bariatric surgery; Complications.; Depression; Quality of life.

MeSH terms

Adult
Anxiety / etiology
Anxiety / psychology
Bariatric Surgery / adverse effects*
Bariatric Surgery / psychology
Depression / etiology
Depression / psychology
Female
Humans
Male
Obesity / surgery
Perioperative Period* / psychology
Postoperative Complications / etiology
Postoperative Complications / psychology*
Psychology
Quality of Life / psychology