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The evolution of depressive symptoms following bariatric surgery for purposes of substantial weight loss


The evolution of depressive symptoms following bariatric surgery for purposes of substantial weight loss

Woods, Robbie ORCID: https://orcid.org/0000-0001-9012-1380 (2022) The evolution of depressive symptoms following bariatric surgery for purposes of substantial weight loss. PhD thesis, Concordia University.

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Depression is the most prevalent psychiatric condition among individuals seeking bariatric surgery for severe obesity (BMI ≥ 40.0 kg/m2; 35.0 with weight-related comorbidities). Following bariatric surgery, depression prevalence and symptom severity are drastically reduced. That said, depression that persists or worsens after bariatric surgery is associated with poorer weight loss outcomes. Psychiatric conditions, e.g., depression, are routinely evaluated during a preoperative psychosocial evaluation when determining suitability for a bariatric procedure. This includes a clinical interview that may be supplemented with screening tools for assessing psychiatric symptoms, e.g., depression. Screening tools are more frequently administered after bariatric surgery in order to monitor how well individuals are adjusting after the procedure. Despite the ubiquity of depressive symptom screening tools, there is a limited understanding of their use in a bariatric population. The current dissertation sought to address the current gaps in the literature regarding depressive symptom screening tools in the bariatric population. The first study consisted of a systematic review and meta-analysis that included 46 studies that examined the evolution of depressive symptoms after individuals had undergone bariatric surgery. Results from the meta-analysis determined that the magnitude that depressive symptoms decreased was similar at 6-, 12-, and 24-months after surgery. The second study examined whether the responses to items within a common depressive symptom screening tool clustered together in a bariatric cohort. This study performed both exploratory and confirmatory factor analyses within two groups and found a model consisting of three subscales was the most appropriate for screening depressive symptoms pre- and post-surgery. The final study examined whether reductions of depressive symptoms overall or within specific subscales were associated with weight loss outcomes. The total and subscale change-scores were tested separately in the association with percent excess-body weight loss. Only the reduction of negative perception features of depression was linked to greater weight loss. Taken together, these studies can inform healthcare professionals about the typical evolution of depressive symptoms up to 24 months after surgery, as well as the depressive symptoms that might be potential targets for intervention if weight loss following bariatric surgery is suboptimal.

Divisions:Concordia University > Faculty of Arts and Science > Psychology
Item Type:Thesis (PhD)
Authors:Woods, Robbie
Institution:Concordia University
Degree Name:Ph. D.
Date:March 2022
Thesis Supervisor(s):Bacon, Simon
ID Code:991943
Deposited By: Robbie Woods
Deposited On:21 Jun 2023 14:47
Last Modified:21 Jun 2023 14:47


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