Laboratoire des Troubles Emotionnels, Centre de Recherche Public Santé, 1A rue Thomas Edison, Strassen, Luxembourg.
Curr Opin Psychiatry. 2010 Jan;23(1):30-6. doi: 10.1097/YCO.0b013e328334c817.
The present editorial review examines current psychological assessment practices in obesity surgery programs, reasons for making such assessments and data obtained prior to surgery and during follow-up. It summarizes findings from previous review articles and reports on new research findings that have been published between August 2006 and August 2009.
Patients with morbid obesity applying for weight loss are commonly administered extensive psychiatric and psychological assessment prior to surgery. Although the value of psychopathological factors for predicting weight loss and mental health after surgery remains controversial, the presence of psychopathology should be taken into account in the presurgery as well as in the postsurgery management of patients undergoing weight-loss surgery.
Morbid obesity is associated with high rates of psychopathology, including depression, anxiety, eating disorders, abnormal personality traits and personality disorders. There is a decrease in psychopathology after obesity surgery in many, though not all, individuals. There is some evidence for poorer postsurgery outcome in individuals with significant presurgery psychopathology, but there is a clear need for more substantial information with regard to reliable psychological predictors of weight loss and mental health after surgery. Whatever the predictive value of psychopathology prior to surgery, it is essential to detect patients in need of psychiatric and/or psychological support after surgery.
目的综述：本社论综述了肥胖症手术项目中当前的心理评估实践、进行此类评估的原因以及手术前和随访期间获得的数据。它总结了之前的综述文章和 2006 年 8 月至 2009 年 8 月期间发表的新研究结果的发现。
最新发现：申请减肥的病态肥胖患者通常在手术前接受广泛的精神科和心理评估。尽管精神病理学因素对预测手术后体重减轻和心理健康的价值仍存在争议，但在手术前和手术后的管理中都应考虑到患者的精神病理学。
总结：病态肥胖与较高的精神病理学发生率相关，包括抑郁、焦虑、饮食失调、异常人格特征和人格障碍。在许多但不是所有个体中，肥胖症手术后精神病理学会减少。在术前有明显精神病理学的个体中，术后结果较差的证据有一些，但需要更多关于手术前后可靠的心理预测体重减轻和心理健康的信息。无论术前精神病理学的预测价值如何，手术后发现需要精神科和/或心理支持的患者都是至关重要的。
