Frontiers in psychiatry · 2026
Depression and anxiety before and after bariatric surgery: a longitudinal cohort study at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
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Alhujaili Naseem Abdulmohi, Alsulami Salhah Saleh, Almutairi Wesam Ayed, Al-Khalawi Eman, Sabbahi Alaa, Alghamdi Abdulaziz Abdullah, Aljiffry Murad
Аннотация
BACKGROUND: Bariatric surgery is an effective long-term treatment for severe obesity. Psychological outcomes after surgery are clinically important.
METHODS: This prospective, non-interventional, longitudinal cohort enrolled adults scheduled for bariatric surgery at King Abdulaziz University Hospital (Jeddah, Saudi Arabia). The participants completed two online questionnaires: one pre-and one post-surgery (planned at approximately 6 months). Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). Positive screening was defined as PHQ-9 ≥10 and GAD-7 ≥10. Weight was self-reported using the questionnaires. Post-surgical complications were self-reported in the post-surgery questionnaire as 'yes/no' items. Pre- and post-surgery scores were compared using the paired t-test. Sensitivity analysis was assessed using the Wilcoxon signed-rank test. Proportions that screened positive were compared using the Z-test. Univariate linear regression was used to assess the association between symptom changes and demographic, clinical, and surgical factors. Analyses were conducted using Stata/AC v18.
RESULTS: Twenty-seven participants completed the pre-surgery questionnaire, and 23 completed the post-surgery questionnaire. The matched analyses included 23 participants. The mean (SD) age was 33.6 (10.4) years, and 11 (47.8%) were female. Although follow-up was planned at approximately 6 months, the completion time varied (mean 359.5 [273.5] days; median 224; range 84-906). The mean (SD) GAD-7 decreased from 6.0 (5.9) to 5.2 (5.5) (p=0.565), while the mean (SD) PHQ-9 decreased from 7.5 (7.3) to 5.9 (6.4) (p=0.430). The proportion screening positive decreased from 26.1% to 17.4% for GAD-7 (p=0.475), and from 26.1% to 13.0% for PHQ-9 (p=0.265). In the univariate models, post-surgical complications were associated with worse anxiety and depression trajectories, while prior anxiety diagnosis was associated with greater improvement in anxiety symptoms.
CONCLUSION: In this cohort, the average depression and anxiety scores declined after bariatric surgery, although the overall changes were not statistically significant. Self-reported post-surgical complications were consistently associated with worse psychological outcomes. Our findings support the need for integrated psychiatric follow-ups during the bariatric surgical evaluations, before surgery and after surgery, particularly in patients with reported complications.
METHODS: This prospective, non-interventional, longitudinal cohort enrolled adults scheduled for bariatric surgery at King Abdulaziz University Hospital (Jeddah, Saudi Arabia). The participants completed two online questionnaires: one pre-and one post-surgery (planned at approximately 6 months). Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). Positive screening was defined as PHQ-9 ≥10 and GAD-7 ≥10. Weight was self-reported using the questionnaires. Post-surgical complications were self-reported in the post-surgery questionnaire as 'yes/no' items. Pre- and post-surgery scores were compared using the paired t-test. Sensitivity analysis was assessed using the Wilcoxon signed-rank test. Proportions that screened positive were compared using the Z-test. Univariate linear regression was used to assess the association between symptom changes and demographic, clinical, and surgical factors. Analyses were conducted using Stata/AC v18.
RESULTS: Twenty-seven participants completed the pre-surgery questionnaire, and 23 completed the post-surgery questionnaire. The matched analyses included 23 participants. The mean (SD) age was 33.6 (10.4) years, and 11 (47.8%) were female. Although follow-up was planned at approximately 6 months, the completion time varied (mean 359.5 [273.5] days; median 224; range 84-906). The mean (SD) GAD-7 decreased from 6.0 (5.9) to 5.2 (5.5) (p=0.565), while the mean (SD) PHQ-9 decreased from 7.5 (7.3) to 5.9 (6.4) (p=0.430). The proportion screening positive decreased from 26.1% to 17.4% for GAD-7 (p=0.475), and from 26.1% to 13.0% for PHQ-9 (p=0.265). In the univariate models, post-surgical complications were associated with worse anxiety and depression trajectories, while prior anxiety diagnosis was associated with greater improvement in anxiety symptoms.
CONCLUSION: In this cohort, the average depression and anxiety scores declined after bariatric surgery, although the overall changes were not statistically significant. Self-reported post-surgical complications were consistently associated with worse psychological outcomes. Our findings support the need for integrated psychiatric follow-ups during the bariatric surgical evaluations, before surgery and after surgery, particularly in patients with reported complications.