Gastric bypass surgery is associated with reduced inflammation and less depression: a preliminary investigation.

BACKGROUND: Prior studies have documented elevated symptoms of depression among patients undergoing gastric bypass surgery, in addition to significant elevations of inflammatory markers including C-reactive protein (CRP) and interleukin-6 (IL-6). No prior study has examined the relationship of changes in depression with change in inflammation among patients undergoing gastric bypass surgery. This pilot study was designed to examine the relationship of inflammation and depression among gastric bypass patients in a 12-month longitudinal study. METHODS: 13 Caucasian women (mean age 46.9 +/- 5.7 years) who were scheduled to undergo a Roux-en-Y gastric bypass (RYGBP) were recruited prior to surgery for measurement of body mass and blood markers of inflammation, as well as self-report measures of depression, quality of life, and disordered eating. 12 months later, subjects completed the same battery of physiological and psychological measures. Data were analyzed with paired t-tests and Pearson correlations. RESULTS: In addition to significant reductions in BMI (P < .001), participants experienced significant reductions in CRP (P < .001), IL-6 (P = .002), and depressive symptoms (P = .025). Reductions also were observed in binge eating (P = .005). Decreased depression during the 12-month follow-up was highly correlated with reduced CRP (r = .98, P < .001). CONCLUSIONS: Results from this pilot study indicate that RYGBP is associated with significant reductions in inflammatory markers of cardiovascular disease risk (e.g., CRP, IL-6) and depressive symptoms, in addition to reductions in weight. Results suggested that reductions in depression were associated with the observed decreases in inflammation.

Concepts in caregiver research.

PURPOSE: To clarify and delineate conceptualizations of the effects of caregiving for nursing research and practice with family caregivers. ORGANIZING CONSTRUCT: The biopsychosocial (psychosocial and physiological) sequelae, both negative and positive, associated with providing care for a relative or friend with a chronic illness. METHODS: Literature reviewed was obtained via searches of CINAHL, MEDLINE, and PsycInfo computerized databases through mid-2002. Key words for the searches were caregiver, caregiving, family caregiving, caregiver burden, and caregiver appraisal. Reports of both earlier reviews of literature and original research were included. FINDINGS: Negative concepts included caregiver burden, hassles, strain, and stress. Positive concepts included caregiver esteem, uplifts of caregiving, caregiver satisfaction, finding or making meaning through caregiving, and gain in the caregiving experience. A neutral concept for describing the caregiving process is caregiver appraisal. Although earlier studies were focused on negative aspects of caregiving, more recent research has also included positive aspects. CONCLUSIONS: More attention should be given to (a) gender and cultural differences in caregiving, (b) development of flexible interventions, and (c) the biophysical sequelae of caregiving.