DEPRESSIVE-DISORDERS AS PSYCHIATRIC COMPLICATIONS AFTER OBESITY SURGERY

Three case reports of morbidly obese patients (two women and a man) wh o underwent vertical banded gastroplasty and who subsequently fell int o depression, are presented here. The psychiatric diagnosis according to DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, 3 rd edition, revised), the eating pattern before obesity surgery, the p ast history of mental disorder, social adaptation before surgery, psyc hological gain from their obese state, and the presence of unrealistic expectations of obesity surgery were investigated. Case 1 was diagnos ed postoperatively as having a major depressive episode without a pers onality disorder. Case 2 was diagnosed postoperatively as having a maj or depressive episode. Case 3 had a depressive disorder not otherwise specified. Cases 2 and 3 had a social phobia with comorbidity of perso nality disorders. Binge eating disorder was confirmed in all patients before obesity surgery. There were differences between case 1 and case s 2 and 3 based on the presence of personality disorder and the time o f onset of depression. When some psychiatric characteristics are confi rmed in obese patients, obesity surgery should be undertaken more prud ently because the patients may manifest depression postoperatively. Th e preoperative psychiatric assessment is essential for a decision on i ndication of obesity surgery.