Changes in clinical depression following Sleeve Gastrectomy

Linking the reversal of gestational insulin resistance to postpartum depression

BACKGROUND

Postpartum depression (PPD) constitutes a significant mental health disorder affecting almost one fifth of pregnancies globally. Despite extensive research, the precise etiological mechanisms underlying PPD remain elusive. However, several risk factors like genetic predisposition, hormonal fluctuations, and stress-related environmental and psychosocial triggers have been found to be implicated in its development. MAIN: Recently, an increased risk of PPD has been reported to be associated with gestational diabetes mellitus (GDM), which is characterized by the disruption of glucose metabolism, primarily attributed to the emergence of insulin resistance (IR). While IR during pregnancy seems to be an evolutionary adaptative mechanism to handle the profound metabolic alterations during pregnancy, its subsequent resolution following delivery necessitates a reconfiguration of the metabolic landscape in both peripheral tissues and the central nervous system (CNS). Considering the pivotal roles of energy metabolism, particularly glucose metabolism, in CNS functions, we propose a novel model that such pronounced changes in IR and the associated glucose metabolism seen postpartum might account for PPD development. This concept is based on the profound influences from insulin and glucose metabolism on brain functions, potentially via modulating neurotransmitter actions of dopamine and serotonin. Their sudden postpartum disruption is likely to be linked to mood changes, as observed in PPD.

CONCLUSIONS

The detailed pathogenesis of PPD might be multifactorial and still remains to be fully elucidated. Nevertheless, our hypothesis might account in part for an additional etiological factor to PPD development. If our concept is validated, it can provide guidance for future PPD prevention, diagnosis, and intervention.

Psychological Scars Shouldn't be Ignored: Addressing Factors Linked to Depression among Individuals with Laparoscopic Sleeve Gastrectomy

Introduction

Although bariatric surgeries have been linked to improved mental health, yet, some individuals develop depression.

Objectives

The present study aimed to assess the levels of depression and examine factors linked to depression among individuals with laparoscopic sleeve gastrectomy (LSG) in Saudi Arabia.

Methods

A cross-sectional design using a digital online survey was used to collect data. Depression was assessed using the Patient Health Questionnaire among individuals with LSG.

Results

A total of 344 eligible participants were included in the study. A significant percentage of the participants, almost one-third, were suffering from depression 27% (n = 94). Moderate to severe depression levels among participants were significantly associated with postoperative complications [odds ratio, OR: 2.92 (95% CI: 1.42-6.01, p = .003)] and having preoperative psychological disorders before LSG [OR: 3.68 (95% CI: 1.88-7.26, p < .001)]. In contrast, lower levels of depression were significantly associated with believing LSG has achieved its goals [OR: 0.46 (95% CI: 0.22-0.97, p = .014)] and recommending LSG to family or friends [OR: 0.15 (95% CI: 0.05-0.44, p = .001)].

Conclusion

There is an evident link between depression and experiencing postoperative complications and suffering from psychological disorders before LSG. The findings of the current study would pave the road for the development of psychological strategies designed to break the cyclic pattern of occurrence of depression as well as optimize the success and maintenance of this treatment modality and support recovery for individuals undergoing LSG.

Associations between GRM7 polymorphisms and obesity in patients selected for sleeve gastrectomy

Obesity is a worldwide problem in which genetic factors have a prominent role. We have selected two single nucleotide polymorphisms (SNPs) within glutamate metabotropic receptor 7 (GRM7) gene, namely rs6782011 and rs779867 to weigh their association with obesity in an Iranian cohort. The distribution of rs6782011 alleles was significantly different in the obese patients from normal controls (P < 0.0001; 434 obese patients vs. 297 normal controls). Distribution of alleles was also measured between sex-based groups of obese patients and controls. We detected remarkable differences between female obese cases and female control subjects (P < 0.0001; 374 female obese cases vs. 216 female normal controls); nevertheless, the difference in allele distribution was not significant for male cases compared with corresponding normal controls (p = 0.47; 60 male patients vs. 81 normal males). Contrariwise, distribution of rs779867 alleles was not significantly different between total obese patients compared with normal controls (P = 0.21; 434 obese patients vs. 297 normal BMI controls). There was also no significant difference for female and male obese patients compared with female and male normal BMI controls. Thus, GRM7 can be considered as a risk locus for obesity.

Is neuregulin-1 (NRG-1) a potential blood biomarker linking depression to obesity? A case-control study

BACKGROUND AND AIM

No definite biomarker linking depression and obesity has been found yet. Our study aimed to investigate neuregulin-1 (NRG-1) as a potential blood biomarker for this association.

METHODS

A case-control study was conducted on 108 obese subjects assigned for laparoscopic sleeve gastrectomy and 100 non-obese controls. Depression was assessed pre- and post-operatively. Serum NRG-1 was measured.

RESULTS

Pre-operatively depression was significantly higher among obese compared to non-obese patients. After the operation, 1.9% of the severely depressed subjects reported no depression, while 5.6% became moderately depressed; about 6% of the moderately depressed and 16% of the mildly depressed became not depressed. Serum NRG-1 level was significantly lower among obese and severely depressed compared to the controls. It was negatively correlated to the level of depression pre- and post-operative (r = -0.764 and -0.467 respectively). The sensitivity of serum NRG1 as a predictor for depression pre- and post-operative was 92.45% and 52.94% respectively. Specificity was 69.09% and 79.73% respectively at cut-off values of ≤ 3.5 and ≤ 2.5 ng/ml.

CONCLUSION

NRG-1 is a possible biomarker for the diagnosis of depression pre-bariatric surgery and the prediction of its prognosis post-operatively.

The Impact of the Epidemiological Situation Resulting From COVID-19 Pandemic on Selected Aspects of Mental Health Among Patients With Cancer-Silesia Province (Poland)

Objective

The study aimed to assess the level of disease acceptance as well as the wellbeing and emotions that accompany cancer patients during the COVID-19 pandemic.

Materials and Methods

The study involved 1,000 patients of the oncology centers (Silesia, Poland). The following questionnaires were used for the study: WHO-5–Well-Being Index, BDI–Beck Depression Inventory, disease acceptance scale, and proprietary multiple-choice questions regarding the impact of the epidemic situation on the respondents’ lives so far. The questionnaire study was conducted twice: in March-October 2020 (the beginning of the COVID-19 pandemic in Poland) and March-October 2021 (renewed tightening of sanitary restrictions in Poland). The differences between the given periods were statistically analyzed.

Results

At the time of the study, the respondents felt mainly anxiety related to the possibility of contracting COVID-19, the possibility of infecting a loved one, or staying in quarantine. Anxiety was also caused by the vision of poorer access to health services. Along with the duration of the epidemic, the acceptance of neoplastic disease has decreased and the incidence of depressive symptoms has increased.

Conclusion

The wellbeing of the respondents deteriorated significantly during the pandemic. The respondents, in their daily functioning, were mainly accompanied by anxiety. The risk of depression has increased and the acceptance of the disease has decreased significantly.

Changes in clinical depression following Sleeve Gastrectomy

INTRODUCTION

Bariatric surgery is safe and efficient surgical method for weight loss, but it is not free from complications. We aim to evaluate the prevalence of depression after Sleeve Gastrectomy (SG) in a narrow period of time on Iranian ethnicity.

METHODS

307 cases that underwent SG in Erfan Niayesh hospital were included. The questionnaire was based on International Classification of Diseases, Ninth Revision (ICD-9) codes to define diagnoses. Screening follow-up period was 20 to 24 months. The level of statistical significance was set at p < .05.

RESULTS

Of 307 subjects, preoperative depression was 30.2% and post-operative depression was 37.7% (p = .025). Besides, BMI, dyslipidaemia, good feelings about body size and weight loss were statistically significant at p < .05.There was an increased risk of depression following the procedure mainly in divorced cases.

CONCLUSION

The prevalence of clinical depression after sleeve gastrectomy was statistically significant and dependent on other variables. We provided guidance for people considering SG and their clinicians in terms of evaluating potential risks and benefits of surgery.