The Association Between Bariatric Surgery and Psychiatric Disorders: a National Cohort Study

Area of Science:

• Medical research
• Surgical outcomes
• Mental health

Background:

• Bariatric surgery is known to improve cardiovascular outcomes.
• The impact of bariatric surgery on psychiatric disorders is less understood.
• This study investigates the differential risk of psychiatric disorders in relation to bariatric surgery.

Purpose of the Study:

• To compare the risk of psychiatric disorders in patients before and after bariatric surgery versus a matched control group.
• To quantify the differential increase in psychiatric disorder risk associated with bariatric surgery.

Main Methods:

• A cohort study design using a national all-payor claims database (PearlDiver-Mariner).
• Inclusion of 56,661 bariatric surgery patients matched with 56,661 individuals with obesity.
• Application of a difference-in-differences (DiD) analysis with 1-year pre- and post-surgery follow-up periods.

Main Results:

• The risk of psychiatric disorders increased from 18% to 70% in bariatric surgery patients one year post-surgery.
• In the control group, psychiatric disorder risk increased from 21% to 46% over the same period.
• DiD analysis revealed a 27 percentage point differential increase (135% relative increase) in psychiatric disorder risk associated with bariatric surgery.

Conclusions:

• Psychiatric disorders increased more significantly in bariatric surgery patients than in matched controls.
• Prevalence of psychiatric disorders was similar before surgery but diverged afterward.
• Integrated behavioral health interventions are crucial for managing psychiatric disorders post-bariatric surgery.