Black D W, Goldstein R B, Mason E E
Department of Psychiatry, University of Iowa College of Medicine, Iowa City 52242.
Am J Psychiatry. 1992 Feb;149(2):227-34. doi: 10.1176/ajp.149.2.227.
The authors sought to determine the association between mental disorder and morbid obesity, defined as weight at least 100% or 100 lb over ideal body weight.
Eighty-eight morbidly obese subjects who had come to a tertiary care center surgery clinic requesting vertical banded gastroplasty were systematically interviewed with the National Institute of Mental Health Diagnostic Interview Schedule (DIS) and the Structured Interview for DSM-III Personality Disorders. A comparison group of 76 psychiatrically normal subjects who were matched in age (within 5 years) and gender to the morbidly obese subjects were also interviewed.
Most of the morbidly obese subjects were women, were of low socioeconomic status as indicated by method of payment for medical care, weighed more than 300 lb, and had been obese for more than 14 years. The morbidly obese subjects were more likely than the comparison group to have a lifetime history of mood disorders, anxiety disorders, bulimia, and tobacco dependence. The morbidly obese subjects were also more likely to meet diagnostic criteria for one or more personality disorders.
Substantial psychopathology exists in morbidly obese individuals requesting gastroplasty, a finding that has important clinical implications.
作者试图确定精神障碍与病态肥胖之间的关联，病态肥胖定义为体重至少比理想体重超出100%或100磅。
对88名到三级护理中心外科诊所要求进行垂直束带胃成形术的病态肥胖受试者，使用美国国立精神卫生研究所诊断访谈表（DIS）和《精神疾病诊断与统计手册》第三版人格障碍结构化访谈进行系统访谈。还对76名年龄（5岁以内）和性别与病态肥胖受试者相匹配的精神正常受试者组成的对照组进行了访谈。
大多数病态肥胖受试者为女性，从医疗费用支付方式来看社会经济地位较低，体重超过300磅，且肥胖超过14年。与对照组相比，病态肥胖受试者更有可能有心境障碍、焦虑障碍、贪食症和烟草依赖的终生病史。病态肥胖受试者也更有可能符合一种或多种人格障碍的诊断标准。
要求进行胃成形术的病态肥胖个体存在大量精神病理学问题，这一发现具有重要的临床意义。
