Childhood Obesity Unit, Skåne University Hospital, Malmö, Sweden.
Obesity (Silver Spring). 2012 Feb;20(2):318-23. doi: 10.1038/oby.2011.310. Epub 2011 Oct 13.
Bariatric surgery is suggested as a treatment option for severely obese adolescents. Because adolescence is characterized by intense psychosocial adjustment and development, it is important to study the effect of this procedure on adolescents' psychological health. This study examined baseline status and short-term changes in anxiety, depression, anger, disruptive behavior, and self-concept in 37 adolescents (mean age 16.6 ± 1.3). Participants completed the Beck Youth Inventories (BYI) at inclusion and (on average) 4 months after undergoing Roux-en-Y gastric bypass (RYGB). Internalizing (anxiety and depression) and externalizing (anger and disruptive behavior) symptoms were higher at baseline than gender-specific norms. One fifth had a very low self-concept. Four months after surgery, the adolescents showed significantly fewer symptoms of anxiety and depression and significantly improved self-concept from baseline. Anger and disruptive behavior showed no significant changes. An analysis of clinically meaningful changes was conducted, and besides the overall positive outcome, 16% (n = 6) of the adolescents had deteriorated on two or more inventories in BYI shortly after surgery. This impaired group did not show any specific features at inclusion. The results indicate the importance of psychological monitoring immediately after bariatric surgery and the need for additional psychosocial support to be available for vulnerable sub-groups of adolescents. Further studies with larger samples are necessary to identify characteristics predictive of short-term adverse psychological outcomes in adolescents after bariatric surgery.
减重手术被建议作为严重肥胖青少年的治疗选择。由于青春期的特点是强烈的心理社会调整和发展，因此研究该手术对青少年心理健康的影响非常重要。本研究在 37 名青少年（平均年龄 16.6 ± 1.3 岁）中，考察了焦虑、抑郁、愤怒、破坏性行为和自我概念的基线状况和短期变化。参与者在纳入时和（平均）接受 Roux-en-Y 胃旁路术（RYGB）后 4 个月完成贝克青年库存（BYI）。内在（焦虑和抑郁）和外在（愤怒和破坏性行为）症状的基线水平高于性别特异性规范。五分之一的人自我概念非常低。手术后 4 个月，青少年的焦虑和抑郁症状明显减少，自我概念从基线显著改善。愤怒和破坏性行为没有明显变化。进行了临床有意义变化的分析，除了整体积极的结果外，手术后不久，16%（n=6）的青少年在两个或更多的 BYI 库存中恶化。这个受损的群体在纳入时没有表现出任何特定的特征。结果表明，在减重手术后立即进行心理监测的重要性，以及为脆弱的青少年亚群提供额外的社会心理支持的必要性。需要进一步进行更大样本的研究，以确定预测青少年减重手术后短期不良心理结果的特征。
