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精神障碍与肥胖症手术患者参与术前和术后咨询小组的情况。

Psychiatric disorders and participation in pre- and postoperative counselling groups in bariatric surgery patients.

机构信息

Section of Mental Health Research, Haugesund Hospital, Helse Fonna HF, P.O. Box 2170, 5504, Haugesund, Norway.

出版信息

Obes Surg. 2011 Jun;21(6):730-7. doi: 10.1007/s11695-010-0146-7.

Abstract

BACKGROUND

Psychological and behavioural factors seem to influence the results of bariatric surgery and the ability to achieve sustained weight loss and subjective wellbeing after the operation. Adequate pre- and postoperative psychological counselling are suggested to improve the results of surgery. However, some patients are reluctant to participate in pre- and postoperative counselling. The aim of the present study was to investigate the possible influence of psychiatric disorders on willingness to participate in group counselling in patients accepted for bariatric surgery.

METHODS

One hundred and forty-one patients referred to bariatric surgery (F/M: 103/38) with mean body mass index (BMI) of 45.2 kg/m2 (SD = 5.3) and mean age of 42.0 years (SD = 10.4) were interviewed with Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview (SCID-II) preoperatively.

RESULTS

The overall prevalence of current psychiatric disorders was 49%. Thirty-one percent did not want to participate in counselling groups. Patients who were unwilling to participate in counselling groups had significantly higher prevalence of social phobia (32%/ 12%, p = 0.006) and avoidant personality disorder (27%/ 12%, p = 0.029) than patients who agreed to participate.

CONCLUSIONS

Psychiatric disorders are prevalent among candidates for bariatric surgery. Social phobia and avoidant personality disorder seem to influence the willingness to participate in counselling groups. Individual counselling and/or web-based counselling might be recommended for bariatric surgery patients who are reluctant to participate in group counselling.

摘要

背景

心理和行为因素似乎会影响减重手术的结果,以及手术后持续减重和主观幸福感的能力。建议进行充分的术前和术后心理咨询,以改善手术效果。然而,一些患者不愿意参加术前和术后咨询。本研究旨在探讨精神障碍对接受减重手术患者参加团体咨询意愿的可能影响。

方法

对 141 名接受减重手术的患者(男/女:103/38)进行了采访,他们的平均 BMI 为 45.2kg/m2(SD=5.3),平均年龄为 42.0 岁(SD=10.4)。术前采用 Mini 国际神经精神访谈(MINI)和结构化临床访谈(SCID-II)进行访谈。

结果

当前精神障碍的总体患病率为 49%。31%的患者不想参加咨询小组。不愿参加咨询小组的患者社交恐惧症(32%/12%,p=0.006)和回避型人格障碍(27%/12%,p=0.029)的患病率明显高于愿意参加的患者。

结论

减重手术候选者中精神障碍较为普遍。社交恐惧症和回避型人格障碍似乎会影响参加咨询小组的意愿。对于不愿意参加小组咨询的减重手术患者,可能需要推荐个体咨询和/或基于网络的咨询。

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