Kim Roy J, Langer Jessica M, Baker Alexander W, Filter Diane E, Williams Noel N, Sarwer David B
Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Obes Surg. 2008 Jan;18(1):27-33. doi: 10.1007/s11695-007-9285-x. Epub 2007 Dec 18.
Little is known about the psychosocial status of adolescents who undergo bariatric surgery. Our objective was to describe the psychological and behavioral characteristics of patients in this age group who underwent bariatric surgery at our institution.
A review of clinical charts of patients aged 14-21 years who had bariatric surgery at our institution between 2000 and 2005 was conducted. Abstracted data included clinical information and the results of a psychosocial evaluation consisting of a clinical interview with a psychologist and self-reported data from the Weight and Lifestyle Inventory and the Beck Depression Inventory-II.
Twenty-five patient records were reviewed. Nineteen patients (76%) were female. The mean (+/-SD) age was 18.7 +/- 1.6 years, and mean body mass index was 50.6 +/- 7.9 kg/m(2). Depression was the most common psychiatric comorbidity (68%). Abnormal eating behaviors were frequent and included binge eating (48%), rapid eating (44%), having guilt associated with eating (36%), eating until uncomfortably full (36%), loss of control (24%), eating without hunger (24%), and eating alone (20%). Sixteen patients were judged to be appropriate for surgery by the bariatric surgery team; surgery was delayed for nine patients primarily because of concerns about ability to adhere to the postoperative diet. These patients were recommended for additional dietary counseling and/or psychotherapeutic treatment prior to surgery.
Among adolescent bariatric surgery candidates, depression and aberrant eating behaviors were very common. Early identification and management of these conditions may enable most of these patients to undergo bariatric surgery and optimize the likelihood for a successful outcome.
对于接受减肥手术的青少年的心理社会状况了解甚少。我们的目的是描述在我们机构接受减肥手术的该年龄组患者的心理和行为特征。
对2000年至2005年间在我们机构接受减肥手术的14至21岁患者的临床病历进行了回顾。提取的数据包括临床信息以及心理社会评估结果，该评估包括与心理学家进行的临床访谈以及来自体重与生活方式量表和贝克抑郁量表第二版的自我报告数据。
审查了25份患者记录。19名患者（76%）为女性。平均（±标准差）年龄为18.7±1.6岁，平均体重指数为50.6±7.9kg/m²。抑郁是最常见的情况（68%）。异常饮食行为很常见，包括暴饮暴食（48%）、进食速度快（44%）、进食有罪恶感（36%）、吃到不舒服的饱腹感（36%）、失控（24%）、不饿时进食（24%）和独自进食（20%）。减肥手术团队判定16名患者适合手术；9名患者的手术被推迟，主要是因为担心其遵守术后饮食的能力。建议这些患者在手术前接受额外的饮食咨询和/或心理治疗。
在青少年减肥手术候选者中，抑郁和异常饮食行为非常常见。对这些情况的早期识别和管理可能使大多数此类患者能够接受减肥手术并优化成功结果的可能性。
