Depression und Suizid/Suizidalität nach adipositaschirurgischen Eingriffen

Zusammenfassung

Ziel: Personen mit schwerer Adipositas profitieren von adipositaschirurgischen Maßnahmen bezüglich Gewichtsabnahme und Reduktion körperlicher Komorbiditäten. Der Artikel fokussiert auf postoperative Depression und Suizidalität/Suizid und stellt eine narrative Überblicksarbeit von rezenten Metaanalysen und kontrollierten Studien dar.

Methodik: Selektive Literatursuche.

Ergebnisse: Es gibt deutliche Hinweise auf eine kurz- bis mittelfristige Reduktion von depressiven Symptomen nach Adipositaschirurgie. Eine Subgruppe von Patienten zeigt längerfristig jedoch eine Wiederzunahme der depressiven Symptomatik oder das erstmalige Auftreten einer depressiven Symptomatik. Große Kohorten-Studien lassen ein erhöhtes Risiko für selbstschädigendes Verhalten und Suizid bei postoperativen Patienten vermuten.

Schlussfolgerungen: Prospektive longitudinale Studien, die das Zusammenspiel von Faktoren untersuchen, die zu Depression und Suizid nach Adipositaschirurgie beitragen, stehen noch aus. Die sowohl prä- als auch postoperativen multi-professionellen Teams sollten immer auch einen Experten für psychische Erkrankungen involvieren, um eine professionelle Diagnostik zu realisieren und Risikopatienten rechtzeitig identifizieren zu können.

Abstract

Purpose: Individuals with severe obesity benefit from bariatric surgery with respect to weight loss and decreases in somatic comorbidity. This paper focuses on postoperative depression and suicidality/suicide and provides a narrative review of recent meta-analyses and controlled studies.

Method: selective literature search.

Results: Considerable evidence shows short and medium-term reduction in depressive symptoms after surgery. However, a subgroup of patients exhibits erosion of these improvements or new onset of depression in the long run. Large cohort studies have found an increased risk for suicide among postoperative patients.

Conclusion: Prospective longitudinal examinations of factors contributing to the increased risk for postoperative depression and suicide and the interaction between these factors are warranted. The inclusion of mental health professionals in bariatric surgery teams would help to monitor patients and identify at-risk patients.

Schlüsselwörter

Adipositaschirurgie - Depression - Suizid - Suizidalität

Key words

Bariatric surgery - Depression - suicide - suicide ideation

• Literatur

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