Herpertz S, Kielmann R, Wolf A M, Langkafel M, Senf W, Hebebrand J
Clinic of Psychosomatic Medicine and Psychotherapy, University of Essen, Essen, Germany.
Int J Obes Relat Metab Disord. 2003 Nov;27(11):1300-14. doi: 10.1038/sj.ijo.0802410.
The objective of this study is to present a review of the psychosocial outcome of bariatric surgery with special consideration of psychiatric comorbidity, psychopathology, psychosocial functioning, econometric data, and general quality of life (QoL).
A review of all (non-) controlled trials of the last two decades both with a retrospective and prospective design and a follow-up period of at least 1 y.
The relevant literature was identified by a search of computerized databases. All articles published in English and German since 1980 were reviewed. Based on the requirements of the evidenced-based guidelines of the Agency for Health Care Policy and Research and the Scottish Intercollegiate Guidelines Network, each study was rated by a level of evidence.
In all, 171 publications were reviewed. Using the above inclusion/exclusion criteria, 63 articles including two systematic reviews were identified. A total of 40 studies focused on psychosocial outcome after obesity surgery.
Mental health and psychosocial status including social relations and employment opportunities improve for the majority of people after bariatric surgery thus leading to an improved QoL. Psychiatric comorbidity, predominantly affective disorders, and psychopathologic symptoms decrease postsurgically. A substantial percentage of bariatric surgery patients suffer from binge eating disorder or binge eating symptoms. The effect of bariatric surgery on the outcome of binge eating symptoms largely depends on the type of operation. With the exception of patients with a severe psychiatric comorbidity, the concern that obesity surgery will reinforce psychic symptoms and lead to a reduction in the QoL seems to be unfounded.
本研究的目的是对减肥手术的心理社会结果进行综述，特别考虑精神疾病共病、精神病理学、心理社会功能、计量经济学数据和总体生活质量（QoL）。
对过去二十年所有（非）对照试验进行综述，采用回顾性和前瞻性设计，随访期至少为1年。
通过检索计算机化数据库确定相关文献。对自1980年以来以英文和德文发表的所有文章进行了综述。根据医疗保健政策和研究机构以及苏格兰校际指南网络循证指南的要求，对每项研究进行证据水平评级。
共综述了171篇出版物。使用上述纳入/排除标准，确定了63篇文章，包括两篇系统评价。共有40项研究关注肥胖手术术后的心理社会结果。
对于大多数人来说，减肥手术后心理健康和心理社会状况包括社会关系和就业机会都会得到改善，从而提高生活质量。精神疾病共病，主要是情感障碍，以及精神病理症状在术后会减少。相当一部分减肥手术患者患有暴饮暴食症或暴饮暴食症状。减肥手术对暴饮暴食症状结果的影响很大程度上取决于手术类型。除了患有严重精神疾病共病的患者外，担心肥胖手术会加重精神症状并导致生活质量下降似乎是没有根据的。
