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寻求腹腔镜可调节胃束带手术的患者与寻求胃旁路手术的患者有何不同?跨种族的心理特征比较。

Do patients seeking laparoscopic adjustable gastric banding surgery differ from those seeking gastric bypass surgery? A comparison of psychological profiles across ethnic groups.

机构信息

Department of Behavioral Sciences, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA.

出版信息

Obes Surg. 2011 Apr;21(4):440-7. doi: 10.1007/s11695-010-0222-z.

Abstract

BACKGROUND

Understanding presurgical psychological functioning is important in determining whether patients may benefit from psychological support before or after undergoing bariatric surgery. However, few studies have directly explored whether presurgical psychosocial profiles differ for patients presenting for different bariatric surgeries and what, if any, impact ethnic background might have. The present study compared presurgical depressive symptomatology, binge eating symptoms, and psychopathology in Caucasian and African American laparoscopic adjustable gastric banding (LAGB) and gastric bypass (RYGB) patients.

METHODS

Patients (n=272) presenting for either LAGB or RYGB surgery completed self-report measures of depressive symptomatology (BDI), binge eating symptoms (BES), and psychopathology/personality (PAI) as part of the presurgical psychological evaluation.

RESULTS

RYGB patients endorsed more depressive symptomatology, binge eating symptoms, somatic complaints, and antisocial features than LAGB patients, though higher BMI in the RYGB patients accounted for differences in binge eating symptoms. When the sample was examined by ethnic group, LAGB-RYGB differences were found only in African American, and not Caucasian, patients.

CONCLUSIONS

Psychosocial profiles appear to differ for African American patients presenting for LAGB and RYGB surgeries; however, some of these differences are accounted for by differences in presurgical BMI. Gaining a better understanding of the initial psychological characteristics of bariatric surgery candidates may improve clinicians' abilities to identify and address specific areas of concern for these patients.

摘要

背景

了解术前心理功能对于确定患者是否可以从减重手术前或手术后的心理支持中获益非常重要。然而,很少有研究直接探讨接受不同减重手术的患者术前社会心理特征是否不同,以及族裔背景是否有任何影响。本研究比较了白人及非裔美国人行腹腔镜可调节胃束带术(LAGB)和胃旁路术(RYGB)患者的术前抑郁症状、暴食症状和精神病理学。

方法

接受 LAGB 或 RYGB 手术的患者(n=272)作为术前心理评估的一部分,完成了抑郁症状(BDI)、暴食症状(BES)和精神病理学/人格(PAI)的自评量表。

结果

RYGB 患者的抑郁症状、暴食症状、躯体主诉和反社会特征比 LAGB 患者更严重,但 RYGB 患者较高的 BMI 解释了暴食症状的差异。当按族裔群体检查样本时,仅在非裔美国患者中发现了 LAGB-RYGB 差异,而在白人群体中没有发现这种差异。

结论

对于接受 LAGB 和 RYGB 手术的非裔美国患者,社会心理特征似乎不同;然而,这些差异中的一些是由术前 BMI 的差异所解释的。更好地了解减重手术候选者的初始心理特征,可能会提高临床医生识别和解决这些患者具体关注点的能力。

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