Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Obes Surg. 2012 Mar;22(3):389-97. doi: 10.1007/s11695-010-0322-9.
Prior studies have reached contradictory conclusions concerning whether binge eating disorder (BED) is associated with greater psychopathology in extremely obese patients who seek bariatric surgery. This study used the Structured Clinical Interview for DSM-IV Diagnoses (SCID) to compare rates of axis I psychopathology in surgery candidates who were determined to have BED or to be currently free of eating disorders. The relationship of BED to other psychosocial functioning and weight loss goals also was examined.
One hundred ninety five bariatric surgery patients completed the Weight and Lifestyle Inventory and the Beck Depression Inventory-II (BDI-II) and were later administered the Eating Disorder Examination. Of these 195, 44 who were diagnosed with BED, and 61 who were currently free of eating pathology, completed a telephone-administered SCID.
Significantly more BED than non-BED participants had a current mood disorder (27.3% vs. 4.9%, p = 0.002) as well as a lifetime history of this condition (52.3% vs. 23.0%, p = 0.003). More BED than non-BED participants also had a current anxiety disorder (27.3% vs. 8.2%, p = 0.014) and lifetime anxiety disorder (36.4% vs. 16.4%, p = 0.019). BED also was associated with greater symptoms of depression, as measured by the BDI-II, as well as with lower self-esteem. BED and non-BED groups, however, did not differ in their desired weight loss goals following surgery.
The present findings indicate that the presence of BED, in patients who seek bariatric surgery, is associated with an increased prevalence of axis I psychopathology, beyond the already elevated rate observed with severe (i.e., class III) obesity.
先前的研究对于暴食障碍（BED）是否与寻求减重手术的极度肥胖患者的更大精神病理学有关得出了相互矛盾的结论。本研究使用 DSM-IV 轴 I 诊断的结构性临床访谈（SCID）来比较患有 BED 或目前无饮食障碍的手术候选者的轴 I 精神病理学发生率。还检查了 BED 与其他心理社会功能和减重目标的关系。
195 名减重手术患者完成了体重和生活方式清单和贝克抑郁量表第二版（BDI-II），随后接受了饮食障碍检查。在这 195 名患者中，有 44 名被诊断为 BED，61 名目前没有饮食病史，完成了电话管理的 SCID。
患有 BED 的参与者比没有 BED 的参与者更有可能患有当前的心境障碍（27.3%比 4.9%，p=0.002）以及这种情况的终生病史（52.3%比 23.0%，p=0.003）。患有 BED 的参与者也比没有 BED 的参与者更有可能患有当前的焦虑症（27.3%比 8.2%，p=0.014）和终生焦虑症（36.4%比 16.4%，p=0.019）。BED 还与 BDI-II 测量的更严重的抑郁症状以及自尊心降低有关。然而，BED 和非 BED 组在手术后期望的减重目标上没有差异。
本研究结果表明，在寻求减重手术的患者中，BED 的存在与轴 I 精神病理学的发生率增加有关，超过了严重（即 3 级）肥胖已经观察到的更高发生率。
