Fabricatore Anthony N, Sarwer David B, Wadden Thomas A, Combs Christopher J, Krasucki Jennifer L
Center for Weight and Eating Disorders, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-3309, USA.
Obes Surg. 2007 Sep;17(9):1213-9. doi: 10.1007/s11695-007-9204-1.
Many bariatric surgery programs require that candidates undergo a preoperative mental health evaluation. Candidates may be motivated to suppress or exaggerate psychiatric symptoms (i.e., engage in impression management), if they believe doing so will enhance their chances of receiving a recommendation to proceed with surgery.
237 candidates for bariatric surgery completed the Beck Depression Inventory-II (BDI-ll) as part of their preoperative psychological evaluation (Time 1). They also completed the BDI-II approximately 2-4 weeks later, for research purposes, after they had received the mental health professional's unconditional recommendation to proceed with surgery (Time 2).
There was a small but statistically significant increase in mean BDI-II scores from Time 1 to Time 2 (11.4 vs 12.7, P<.001). Clinically significant changes, defined as a change from one range of symptom severity to another, were observed in 31.2% of participants, with significant increases in symptoms occurring nearly twice as often as reductions (20.7% vs 10.5%, P<.008). Demographic variables were largely unrelated to changes in BDI-II scores from Time 1 to Time 2.
Approximately one-third of bariatric surgery candidates reported a clinically significant change in depressive symptoms after receiving psychological "clearance" for surgery. Possible explanations for these findings include measurement error, impression management, and true changes in psychiatric status.
许多减肥手术项目要求候选人接受术前心理健康评估。如果候选人认为这样做会增加获得手术推荐的机会，他们可能会有动机去抑制或夸大精神症状（即进行印象管理）。
237名减肥手术候选人在术前心理评估（时间1）时完成了贝克抑郁量表第二版（BDI-II）。大约2至4周后，在他们收到心理健康专业人员关于进行手术的无条件推荐后，为了研究目的，他们又完成了BDI-II（时间2）。
从时间1到时间2，BDI-II平均得分有小幅但在统计学上显著的增加（11.4对12.7，P<.001）。31.2%的参与者出现了临床上显著的变化，即从一个症状严重程度范围转变为另一个范围，症状显著增加出现的频率几乎是减少的两倍（20.7%对10.5%，P<.008）。人口统计学变量在很大程度上与从时间1到时间2的BDI-II得分变化无关。
大约三分之一的减肥手术候选人在获得手术的心理“许可”后报告了抑郁症状的临床上显著变化。这些发现的可能解释包括测量误差、印象管理和精神状态的真实变化。
