Department of Surgery, Stanford University School of Medicine, Stanford, CA 94304, USA.
Surg Endosc. 2010 Aug;24(8):1892-7. doi: 10.1007/s00464-009-0866-8. Epub 2010 Jan 9.
The veteran population is routinely screened for post-traumatic stress disorder (PTSD). The prevalence of obesity in this population continues to increase. We examined whether weight loss outcomes in veterans with PTSD is comparable to results in veterans who do not suffer from PTSD, after gastric bypass. We also examined the effect of bariatric surgery on PTSD symptoms.
This retrospective review of prospective data compares veterans with and without PTSD who underwent laparoscopic gastric bypass. Differences between the means of age, initial BMI, and percent excess weight loss were compared between the groups using a Student's t test. Pearson's chi(2) was used to evaluate the relationship between a diagnosis of PTSD, major depressive disorder (MDD), and other Axis I psychiatric disorders. A similar analysis was done to assess for a relationship between PTSD and obesity-related comorbidities, including diabetes mellitus (DM), hypertension (HTN), hyperlipidemia, and GERD.
We identified 24 patients who had gastric bypass and a diagnosis of PTSD before surgery and compared them to those without PTSD. Both groups had a similar mean age and initial BMI. There was no significant difference between the percent excess weight lost after 1 year follow-up between the PTSD group (66%) and the non-PTSD group (72%) (p = 0.102). In assessing comorbid conditions, we found a significant association between the diagnosis of PTSD and MDD (p = 0.002), PTSD and other Axis I disorders (p = 0.004), and PTSD and GERD (p = 0.002). However, we saw no significant association between PTSD and DM (p = 0.977), HTN (p = 0.332), and obstructive sleep apnea (OSA) (p = 0.676). The severity of PTSD symptoms fluctuated in the postoperative period.
Veterans with PTSD have comparable weight loss to those without PTSD after gastric bypass. In addition, surgery does not seem to have an adverse effect on PTSD symptoms, although PTSD symptomatology tends to fluctuate over time. Further study in this patient population is warranted.
老年人群常规接受创伤后应激障碍（PTSD）筛查。该人群的肥胖患病率持续上升。我们研究了 PTSD 退伍军人与非 PTSD 退伍军人在接受胃旁路手术后减肥效果是否相当。我们还研究了减重手术对 PTSD 症状的影响。
这项前瞻性数据的回顾性研究比较了接受腹腔镜胃旁路手术的 PTSD 退伍军人和非 PTSD 退伍军人。使用学生 t 检验比较两组之间年龄、初始 BMI 和超重减轻百分比的平均值之间的差异。使用 Pearson's chi(2)评估 PTSD、重度抑郁症（MDD）和其他轴 I 精神障碍诊断之间的关系。对 PTSD 与肥胖相关合并症（包括糖尿病、高血压、高脂血症和 GERD）之间的关系进行了类似的分析。
我们确定了 24 名手术前患有 PTSD 的胃旁路手术患者，并将他们与无 PTSD 的患者进行了比较。两组的平均年龄和初始 BMI 相似。在 1 年随访后，PTSD 组（66%）和非 PTSD 组（72%）的超重减轻百分比之间没有显著差异（p = 0.102）。在评估合并症时，我们发现 PTSD 与 MDD（p = 0.002）、PTSD 与其他轴 I 障碍（p = 0.004）和 PTSD 与 GERD（p = 0.002）之间存在显著关联。然而，我们没有发现 PTSD 与糖尿病（p = 0.977）、高血压（p = 0.332）和阻塞性睡眠呼吸暂停（OSA）（p = 0.676）之间存在显著关联。PTSD 症状的严重程度在术后期间波动。
PTSD 退伍军人在接受胃旁路手术后的减肥效果与非 PTSD 退伍军人相当。此外，尽管 PTSD 症状随时间波动，但手术似乎对 PTSD 症状没有不良影响。需要在这一患者群体中进行进一步研究。
