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极度肥胖患者:胃束带术后三年精神症状的变化

Patients with extreme obesity: change in mental symptoms three years after gastric banding.

作者信息

Nickel C, Widermann C, Harms D, Leiberich P L, Tritt K, Kettler C, Lahmann C, Rother W K, Loew T H, Nickel M K

机构信息

Clinic for Psychosomatic Medicine, Germany.

出版信息

Int J Psychiatry Med. 2005;35(2):109-22. doi: 10.2190/ANYR-WE1M-39G5-K92D.

Abstract

OBJECTIVE

Extreme obesity causes grave psychosocial and psychopathological problems in addition to somatic morbidity. One possible treatment is gastric banding, a surgical reduction of stomach volume. The aim of this study was to investigate whether gastric banding leads to lasting change in: 1) the Body Mass Index (BMI); 2) social factors such as work and partnerships, eating behavior, anxiety and depression symptoms; and 3) health related quality of life.

METHOD

We surveyed a sample of 50 adipose women (BMI > 40 kg/m2). Primary outcome measures were self-reported changes on the scales of the Three-Factor Eating Questionnaire (TFEQ), the Hospital Anxiety and Depression Scale (HADS-D), and the Health Survey (SF-36).

RESULTS

In comparison with the control group, we observed significant changes in BMI (p < 0.01) and the existence of a partnership (p < 0.01), on all three scales of the TFEQ (p < 0.01), on both scales of the HADS-D (anxiety: p < 0.05; depression:p < 0.01), and on all scales of the SF-36 Health Survey (p between < 0.05 and < 0.01 in every case). The most marked changes in all the qualities investigated occurred within the first 12 months of surgery.

CONCLUSIONS

Three years after gastric banding, positive changes in BMI reduction, partnership, eating behavior, anxiety, depressive symptomatology, and health related quality of life could be observed. There was also a significant correlation between BMI reduction and reduction firstly on the depression scale (HADS-D) and secondly on the SF-36 scales for physical functioning (PHFU), role physical (ROPH), mental health (PSYC), and vitality (VITA).

摘要

目的

除了躯体疾病外,极度肥胖还会引发严重的心理社会和精神病理学问题。一种可能的治疗方法是胃束带术,即通过手术减小胃容量。本研究的目的是调查胃束带术是否会在以下方面产生持久变化:1)体重指数(BMI);2)社会因素,如工作和伴侣关系、饮食行为、焦虑和抑郁症状;3)与健康相关的生活质量。

方法

我们对50名肥胖女性(BMI>40kg/m²)进行了调查。主要结局指标是在三因素饮食问卷(TFEQ)、医院焦虑抑郁量表(HADS-D)和健康调查(SF-36)量表上的自我报告变化。

结果

与对照组相比,我们观察到BMI(p<0.01)、伴侣关系的存在(p<0.01)、TFEQ所有三个量表(p<0.01)、HADS-D的两个量表(焦虑:p<0.05;抑郁:p<0.01)以及SF-36健康调查的所有量表(每种情况p在<0.05和<0.01之间)均有显著变化。在所有调查的特质中,最显著的变化发生在手术后的前12个月内。

结论

胃束带术后三年,可以观察到BMI降低、伴侣关系、饮食行为、焦虑、抑郁症状以及与健康相关的生活质量方面的积极变化。BMI降低与抑郁量表(HADS-D)以及SF-36身体功能(PHFU)、角色身体(ROPH)、心理健康(PSYC)和活力(VITA)量表的降低之间也存在显著相关性。

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