Case Series Examining Depressive Symptoms and Use of Behavioral Health Services in Bariatric Surgery Patients with Multiple Sclerosis

Background: Multiple Sclerosis (MS) is associated with high rates of both obesity and depression. Functional limitations associated with MS in addition to commonly prescribed medications with obesiogenic side effects (e.g., steroids) make it increasingly difficult for obese individuals with MS to obtain clinically significant weight loss through traditional methods. Preliminary evidence indicates that bariatric surgery may be a safe and effective intervention for morbidly obese patients with MS to achieve weight loss and improve function. However, untreated preoperative depression is an important and relevant factor that has the potential to adversely impact postoperative physical and mental health outcomes. It is currently unknown how depression may present in morbidly obese, surgery-seeking individuals with MS, how surgery may impact these symptoms, and how this population utilizes behavioral health services.

Objectives: The current study aims to gain a better understanding of the prevalence and nature of pre- and postoperative depressive symptoms and use of behavioral health services in morbidly obese individuals with MS seeking bariatric surgery.

Methods: A database of 2,918 bariatric surgery patients was retrospectively reviewed, yielding 16 morbidly obese MS patients who underwent bariatric surgery at our site between 2004 and 2011. We plan to re-review this database to gain an updated list of patients; thus, our total N is expected to grow by June of 2016. Pre- and postoperative PHQ-9 data, preoperative behavioral health consults, and follow-through with behavioral health services, will be compared using Fisher's exact tests. 

Results: In progress.

Conclusions: Results of this study will provide important, preliminary information on depressive symptoms in this under-studied population, which has relevance for both medical and psychological outcomes in the treatment of obesity in MS. In addition, these data will help delineate whether these individuals are receiving adequate mental health treatment at our site, and would provide implications for future mental health treatment for this population.