Department of Surgery, Hospital Clinico Universitario de Valencia, University of Valencia, Valencia, Spain.
Surg Obes Relat Dis. 2012 Nov-Dec;8(6):770-6. doi: 10.1016/j.soard.2011.03.015. Epub 2011 Apr 19.
Morbid obesity is associated with debilitating psychosocial consequences, such as depression, anxiety, and low self-esteem. One of the main goals of bariatric surgery should not only be reducing weight and counteracting co-morbid conditions, but also improving postoperative psychosocial functioning. The objective of our study was to determine the preoperative variables that could predict the psychological symptoms 6 and 12 months after surgery to improve the clinical outcome of morbidly obese patients undergoing bariatric surgery. The setting was a university hospital in Spain.
The study group consisted of 60 morbidly obese patients (46 women and 14 men) who had undergone gastric bypass surgery for weight reduction and had ≥ 1 year of follow-up. The patients were evaluated using different questionnaires (Symptom Checklist-90-Revised, Body Shape Questionnaire, Rosenberg Self-Esteem Questionnaire, COPE, Medical Outcomes Study Social Support Survey) at 3 points: before surgery, at 6 months postoperatively, and at 1 year postoperatively. To determine the influence of preoperative variables on long-term psychological status, a step-by-step multivariate linear regression analysis was performed, taking P < .05 as statistically significant.
The variables of self-esteem, instrumental support, and coping focused in the emotions were the main preoperative predictors for psychological symptoms 6 months after surgery. Preoperative drug abuse as a strategy of problem solving and mainly body image significantly predicted most of the psychological disorders 1 year after surgery.
The study of different psychosocial variables in patients before bariatric surgery is an important aid to predict postoperative psychological functioning. Self-esteem and body image were the most influential factors in the postoperative psychological outcome of morbidly obese patients in our study.
病态肥胖与衰弱的心理社会后果相关，如抑郁、焦虑和低自尊。减重手术的主要目标不仅应是减轻体重和对抗合并症，还应改善术后心理社会功能。我们研究的目的是确定术前变量，这些变量可以预测术后 6 个月和 12 个月的心理症状，以改善接受减重手术的病态肥胖患者的临床结局。该研究在西班牙的一家大学医院进行。
研究组包括 60 名病态肥胖患者（46 名女性和 14 名男性），他们因减重而行胃旁路手术，且随访时间≥1 年。患者在 3 个时间点接受不同的问卷评估（症状清单 90 修订版、身体形状问卷、罗森伯格自尊量表、应对方式量表、医疗结局研究社会支持量表）：术前、术后 6 个月和术后 1 年。为了确定术前变量对长期心理状态的影响，进行了逐步多元线性回归分析，以 P<.05 为统计学显著。
自尊、工具性支持和情绪应对是术后 6 个月心理症状的主要术前预测因素。术前作为解决问题策略的药物滥用和主要的身体形象显著预测了术后 1 年大多数心理障碍。
在减重手术前研究患者的不同心理社会变量是预测术后心理功能的重要辅助手段。在我们的研究中，自尊和身体形象是病态肥胖患者术后心理结局的最主要影响因素。
