The Effect Of Bariatric Surgery On Anxiety And The Factors Associated With Patients’ Preoperative Anxiety

Background: Anxiety is a worried emotion that arises from excessive human worry about future threats.Anxiety is a normal emotion that is adapted to human evolution and drives humans to avoid danger to promote survival.However,excessive anxiety can lead to disruptions in life and social functioning.In several studies,it has been shown that bariatric surgery patients tend to have more positive personality traits compared to obese patients who do not opt for bariatric surgery.Also,studies have found that bariatric surgery can reduce the prevalence and severity of anxiety and depression in obese patients.The domestic and international literature has mostly focused on reports of bariatric effects and mechanisms,while domestic related psychological studies are less frequent and lack attention to the preoperative psychological state of bariatric surgery patients.Objective: This study investigated the anxiety and psychological disorders of obese patients before bariatric surgery,analyzed the effects of bariatric surgery on patients’ metabolism and anxiety,analyzed the factors associated with anxiety in preoperative patients,and explored the correlation between them and body mass index(BMI).To provide some evidence support for further targeted research and scientific interventions.Methods: Obese patients proposed for laparoscopic sleeve gastrectomy(LSG)at the Weight Loss Metabolic Center of the Second People’s Hospital of XXXXX from August2017 to October 2021 were retrospectively analyzed,and general demographic data and clinical data were collected.The Self-Rating Anxiety Scale(SAS)was used to investigate the patients’ anxiety status and degree,and the Chinese Health Questionnaire(CHQ-12)was used to assess the patients’ psychological disorders.Non-parametric tests were used to compare the patient data before and 3 months after surgery.Multi-factor logistic regression models were used to analyze the factors associated with anxiety.The relationship between patients’ BMI and anxiety was analyzed using methods such as smoothed curve fitting and multiple segmented linear regression.Statistical calculations were performed using Empower Stats 4.0 and R 4.2.0 software for statistical analysis.Results:1.Of the 310 patients with obesity who sought weight loss surgery,23.2% were male;76.8% were female.Age was 31(25,36)years.BMI 36.80(33.01,41.53)kg/m2.205cases(66.1%)were married.194 cases(65.3%)received higher education.2.In the comparison of obesity and metabolic indexes of patients before and 3months after operation,body weight,BMI,chest circumference,waist circumference,hip circumference,uric acid(UA),triglyceride(TG),fasting blood-glucose(FBG),etc.were significantly improved,with statistical difference(P<0.01),while total cholesterol(TC)was not significantly different(P>0.05).3.In the analysis of preoperative and postoperative 3 months SAS and CHQ-12 scores and prevalence,preoperative patients had a standardized SAS score of 41.25(35,47.5)and positive anxiety symptoms in 62 cases(20.0%);CHQ-12 score of 2(2,4)and positive psychological disorders in 82 cases(27.5%);postoperative patients had a standardized SAS score of 35.00 in 3 months(28.75,40.63),11 cases(6.8%)were positive for anxiety symptoms;patients showed remission in both SAS scores and prevalence at 3 months postoperatively compared to preoperatively,with a significant difference(P<0.01).4.In comparing the preoperative mental health of bariatric surgery patients in the high and low BMI groups,the risk of anxiety disorders was lower in the high BMI group than in the low BMI group,with a significant difference(P < 0.01),and there was no statistical difference between the two groups in the presence or absence of psychological disorders(P > 0.05).5.In the correlated factor analysis of anxiety in patients before bariatric surgery,BMI,motivation for weight loss,being from the region,diabetes,and gastroesophageal reflux were found to be associated with patient anxiety in the univariate analysis(P <0.05).Significant differences remained after adjustment for BMI,motivation to lose weight,being from the region,diabetes,and gastroesophageal reflux(P < 0.05).6.In the analysis of the curve fitting of the association between preoperative BMI and anxiety in patients undergoing bariatric surgery and with the threshold effect analysis,the uncorrected model smoothed curve showed a trend of first decreasing and then increasing,and the inflection point BMI was calculated to be at 38.9 kg/m2 by a twosegment linear regression model,with an association on the left side of the inflection point(P < 0.05),and no association on the right side of the inflection point(P > 0.05).In the corrected model,the curves of patients’ BMI and anxiety were fitted in a straight line with an approximate negative correlation and no inflection point,and the prevalence of patients’ anxiety decreased with increasing BMI(P < 0.05).Conclusion: The prevalence of preoperative anxiety in patients undergoing bariatric surgery is high and is associated with many factors,and bariatric surgery can not only improve metabolism but also improve patients’ anxiety in the short term.