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胃束带术后极度肥胖患者精神症状的变化,第二部分:六年随访

Change in mental symptoms in extreme obesity patients after gastric banding, Part II: Six-year follow up.

作者信息

Nickel M K, Loew T H, Bachler E

机构信息

Clinic for Psychosomatic Medicine and Psychotherapy, Medical University of Graz, Austria.

出版信息

Int J Psychiatry Med. 2007;37(1):69-79. doi: 10.2190/X40R-712P-8J44-0L3H.

Abstract

OBJECTIVE

Apart from increased somatic morbidity, extreme obesity causes grave psychosocial and psychopathological problems. We examined a sample of 50 extremely adipose women (BMI < 40 kg/m2) from 2000 to 2003 to find out whether surgical reduction of stomach volume leads to lasting change in Body Mass Index (BMI), psychosocial symptoms, and health related quality of life. We found that positive changes in BMI reduction, psychosocial symptoms, and health related quality of life could be expected three years after gastric banding (Int. J Psychiatry Med 2005; 35:109-122). During the following three years, we continued to observe these patients to determine long-term effects.

METHOD

Fifty adipose women who had taken part in the first study from 2004 to 2006 were surveyed. Annual primary outcome measures were BMI, self-reported changes on the scales of the Three-Factor Eating Questionnaire (TFEQ), Hospital Anxiety and Depression Scale (HADS-D), and Health Survey (SF-36).

RESULTS

At the 6-year mark, significant changes in BMI (p < 0.01), significantly increased employment (0.012) and the existence of a partnership (p < 0.01), plus significant changes on all three scales of the TFEQ (p < 0.01), on both scales of the HADS-D (anxiety: p < 0.05; depression: p < 0.011), and all scales of the SF-36 Health Survey (all p < 0.01) were observed.

CONCLUSIONS

The positive changes in BMI reduction, i.e., increased employment and subjects living in a partnership, improvement in eating behavior, reduction in anxiety and depressive symptoms, and improvement in health related quality of life were also confirmed as remaining stable over a 3-year observation period, i.e., for a total of six years.

摘要

目的

除了躯体发病率增加外,极度肥胖还会引发严重的心理社会和精神病理问题。我们在2000年至2003年期间对50名极度肥胖女性(体重指数<40kg/m²)进行了抽样研究,以确定手术缩小胃容积是否会导致体重指数(BMI)、心理社会症状以及与健康相关的生活质量产生持久变化。我们发现,胃束带手术后三年,BMI降低、心理社会症状以及与健康相关的生活质量有望出现积极变化(《国际精神病学医学杂志》2005年;35:109 - 122)。在接下来的三年里,我们继续观察这些患者以确定长期效果。

方法

对2004年至2006年参与第一项研究的50名肥胖女性进行调查。年度主要观察指标为BMI、三因素饮食问卷(TFEQ)量表、医院焦虑抑郁量表(HADS - D)以及健康调查(SF - 36)的自我报告变化。

结果

在6年时,观察到BMI有显著变化(p < 0.01),就业显著增加(0.012)以及有伴侣关系(p < 0.01),此外,TFEQ的所有三个量表(p < 0.01)、HADS - D的两个量表(焦虑:p < 0.05;抑郁:p < 0.011)以及SF - 36健康调查的所有量表(均p < 0.01)都有显著变化。

结论

BMI降低的积极变化,即就业增加和有伴侣关系的受试者增多、饮食行为改善、焦虑和抑郁症状减轻以及与健康相关的生活质量提高,在3年观察期内,即总共6年期间也被证实保持稳定。

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