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肥胖症患者行减重手术候选人的童年期父母丧失与双相谱系障碍。

Childhood parental loss and bipolar spectrum in obese bariatric surgery candidates.

机构信息

Department of Psychiatry, Luigi Sacco University Hospital, Milan, Italy.

出版信息

Int J Psychiatry Med. 2011;41(2):155-71. doi: 10.2190/PM.41.2.e.

Abstract

BACKGROUND

Early adverse experiences such as sexual, verbal, or physical abuse and parental neglect have been associated with a higher risk of weight or eating problems in adulthood, and death or prolonged separation from parents during childhood has been implicated as a correlate of adult psychiatric disorders that are widely represented in obese subjects seeking bariatric surgery.

OBJECTIVE

The aim of this study was to examine the rate of childhood parental loss in obese bariatric surgery candidates and explore its association with a psychiatric diagnosis and clinical and weight/eating-related characteristics.

METHODS

The current and lifetime psychiatric diagnoses of 120 consecutive bariatric patients undergoing pre-surgical psychiatric consultation were assessed using a modified version of the Structured Clinical Interview for DSM-IV (SCID-CV), and information relating to parental death or separation before the age of 17 years was collected using a semi-structured interview. The rate of childhood parental loss was compared with that of an always slender population sharing the same psychiatric diagnosis.

RESULTS

91.7% of the obese subjects were diagnosed as having a bipolar spectrum disorder. Overall, 28% of the patients reported a childhood parental death or separation. Early parental loss was not equally distributed in the different diagnostic subgroups, being more frequent in those with bipolar II disorders; the always slender subjects with bipolar II disorders showed a lower rate of early parental loss.

CONCLUSIONS

The study findings confirm the association between obesity and bipolar disorders and suggest that early parental loss may play a role in the development of obesity in bipolar II subjects.

摘要

背景

早期的不良经历,如性虐待、言语虐待或身体虐待以及父母忽视,与成年后患体重或饮食问题的风险增加有关,而童年时期与父母死亡或长期分离,与成年期广泛存在于寻求减肥手术的肥胖患者中的精神障碍有关。

目的

本研究旨在检查肥胖减肥手术候选者的童年期父母丧失率,并探讨其与精神诊断以及临床和体重/饮食相关特征的关系。

方法

使用 DSM-IV 修订版结构临床访谈(SCID-CV)评估了 120 名连续接受减肥手术前精神咨询的肥胖患者的当前和终身精神诊断,并使用半结构化访谈收集了 17 岁前父母死亡或分离的信息。将童年期父母丧失率与具有相同精神诊断的始终苗条人群进行比较。

结果

91.7%的肥胖患者被诊断为双相谱系障碍。总体而言,28%的患者报告了童年期父母死亡或分离。早期父母丧失在不同诊断亚组中分布不均,在双相 II 障碍患者中更为常见;具有双相 II 障碍的始终苗条人群中,早期父母丧失的比例较低。

结论

研究结果证实了肥胖与双相障碍之间的关联,并表明早期父母丧失可能在双相 II 障碍患者肥胖的发展中起作用。

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