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Previous research indicates that anxiety and depressive symptoms could be associated with GI complaints. This study aims to investigate the association between anxiety and\/or depressive symptoms and GI complaints five years after MBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional study 220 participants who underwent MBS were included. Self-reported anxiety and\/or depressive symptoms were measured with the\n                      <jats:italic>Hospital Anxiety and Depression Scale<\/jats:italic>\n                      and GI complaints with the\n                      <jats:italic>Gastrointestinal Symptom Rating Scale<\/jats:italic>\n                      . Differences in GI complaint scores between participants with no, mild or severe anxiety and\/or depression symptoms were assessed using\n                      <jats:italic>Kruskal-Wallis<\/jats:italic>\n                      and post-hoc tests. Furthermore, the association between anxiety and\/or depressive symptom categories and moderately-severe to severe GI complaints (any GRSR item score\u2009\u2265\u20095 out of 7) was assessed by modified\n                      <jats:italic>Cox<\/jats:italic>\n                      regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants were on average 50\u2009\u00b1\u200911 years of age five years post-MBS, mostly female (81%) and predominantly underwent RYGB (87%). 28% reported anxiety and\/or depressive symptoms, of which 15% mild and 13% severe. 42% of participants reported moderately-severe to severe GI complaints, of which 20% was severe. Participants with severe anxiety and\/or depressive symptoms had significantly higher total and domain GI complaint scores (abdominal pain, reflux syndrome, constipation syndrome) than participants without these symptoms (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;.001). Similar trends were found in participants with mild anxiety and\/or depressive symptoms (total\n                      <jats:italic>p<\/jats:italic>\n                      &lt;.001, reflux syndrome\n                      <jats:italic>p<\/jats:italic>\n                      =.048, constipation syndrome\n                      <jats:italic>p<\/jats:italic>\n                      =.005), the association with abdominal pain was on the borderline of significance (\n                      <jats:italic>p<\/jats:italic>\n                      =.05). Participants with mild or severe anxiety and\/or depressive symptoms respectively had a 1.75 (95%CI 0.98\u20133.11; not statistically significant) and 2.55 (95%CI 1.45\u20134.47) times higher risk (BMI and sleep adjusted prevalence ratio\u2019s) of experiencing moderately-severe to severe GI complaints compared to those without.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Participants 5-years post-MBS with mild to severe self-reported anxiety and\/or depressive symptoms are at a higher risk of reporting more severe GI complaints. These findings underscore the need to assess and refer anxiety and\/or depressive symptoms when counselling patients after MBS with GI complaints.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08899-5","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:20:45Z","timestamp":1789996845000},"page":"5307-5315","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association between Anxiety and\/or Depression Symptoms with Gastrointestinal Complaints Five Years after Metabolic and Bariatric Surgery - a Cross-sectional Study"],"prefix":"10.1007","volume":"36","author":[{"given":"Nadia","family":"Botros","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonta G.R.","family":"van der Burgh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura N.","family":"Deden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elske M.","family":"van den Berg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3459-0603","authenticated-orcid":false,"given":"Agnes A.M.","family":"Berendsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Hazebroek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"8899_CR1","doi-asserted-by":"publisher","unstructured":"Law S, Dong S, Zhou F, Zheng D, Wang C, Dong Z. 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