Outcomes of Bariatric Surgery in Patients With Bipolar and Schizophrenia Spectrum Disorders: A Systematic Review and Meta-analysis.

Abstract

Psychiatric disorders, particularly bipolar disorder (BD) and schizophrenia spectrum disorders (SCZ), are associated with high rates of obesity and metabolic diseases. This systematic review and meta-analysis evaluates the efficacy of bariatric surgery in BD/SCZ patients, aiming to inform clinical decisions and optimize treatment strategies for this population. MEDLINE, Embase, and Cochrane databases were searched up to September 2024. A restricted maximum likelihood random-effects model with mean differences (MD) for continuous outcomes and odds ratios (ORs) for binary outcomes, along with 95% confidence intervals (CI), was used. 13 studies involving 19,662 patients, of whom 1,117 (5.7%) were diagnosed with BD or SCZ, were included. The analysis revealed no significant differences in %TWL or BMI change at 6 months, 1 year, and 2 years. BD/SCZ patients showed a significantly smaller %EWL at 6 months; however, the differences at 1 and 2 years were no longer statistically significant. Similarly, no differences were found between BD/SCZ patients and controls regarding adherence to 6-month, 1-year, and 2-year follow-up, as well as 1-year remission rates of type 2 diabetes mellitus, hypertension, obstructive sleep apnea syndrome, dyslipidemia, or 30-day readmission and reoperation rates. Data from included studies also indicated no exacerbation of psychiatric disorders after surgery. This study suggests that bariatric surgery may be similarly effective in patients with BD and SCZ, offering potential benefits for a population burdened with both psychiatric and physical health challenges.