Pre- and Postoperative Risk of Psychiatric Disorders: Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass

Introduction: Previous research has reported that patients undergoing bariatric surgery commonly experience debilitating psychopathology, both in the pre- and postoperative phases. However, it is unknown whether the surgical procedure type (sleeve gastrectomy (SG) vs Roux-en-Y gastric bypass (RYGB)) is associated with a differential risk of psychiatric disorders, providing the objective of our study. Methods: We conducted a retrospective cohort study employing PearlDiver Mariner, a national all-payer administrative database, to identify patients eligible for bariatric surgery who underwent SG or RYGB from January 2010 to October 2020. The differential risk of psychiatric disorders between SG and RYGB patients from one year before to one year after surgery was evaluated using difference-in-differences (DiD) regression. Results: The matched cohort included 34,517 patients in each group. The risk of preoperative psychiatric disorders among RYGB and SG patients was comparable (16% vs 15%). The risk of psychiatric disorders in the postoperative period increased among both groups, but to a larger extent among those who underwent RYGB (75% vs 69%). DiD analysis suggests that RYGB was associated with a 5% absolute increase (p < 0.0001) in the probability of psychiatric disorders, for a relative increase of 33%. Conclusion: This is the first study to compare the risk of psychiatric disorders between RYGB and SG patients in a large cohort. Since psychopathology was not on par between the two groups, patients undergoing bariatric surgery may decide to undergo SG in order to prevent excess risk of psychiatric disorders.