Neuropsychiatric Research Institute, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota 58102, USA.
Surg Obes Relat Dis. 2012 Sep-Oct;8(5):533-41. doi: 10.1016/j.soard.2012.07.001. Epub 2012 Jul 14.
Current and previous psychopathology in bariatric surgery candidates is believed to be common. Accurate prevalence estimates, however, are difficult to obtain given that bariatric surgery candidates often wish to appear psychiatrically healthy when undergoing psychiatric evaluation for approval for surgery. Also, structured diagnostic assessments have been infrequently used.
The present report concerned 199 patients enrolled in the longitudinal assessment of bariatric surgery study, who also participated in the longitudinal assessment of bariatric surgery-3 psychopathology substudy. The setting was 3 university hospitals, 1 private not-for-profit research institute, and 1 community hospital. All the patients were interviewed independently of the usual preoperative psychosocial evaluation process. The patients were explicitly informed that the data would not be shared with the surgical team unless certain high-risk behaviors, such as suicidality, that could lead to adverse perioperative outcomes were reported.
Most of the patients were women (82.9%) and white (nonwhite 7.6%, Hispanic 5.0%). The median age was 46.0 years, and the median body mass index was 44.9 kg/m2. Of the 199 patients, 33.7% had ≥1 current Axis I disorder, and 68.8% had ≥1 lifetime Axis I disorder. Also, 38.7% had a lifetime history of a major depressive disorder, and 33.2% had a lifetime diagnosis of alcohol abuse or dependence. All these rates were much greater than the population-based prevalence rates obtained for this age group in the National Comorbidity Survey-Replication Study. Also, 13.1% had a lifetime diagnosis and 10.1% had a current diagnosis of a binge eating disorder.
The current and lifetime rates of psychopathology are high in bariatric surgery candidates, and the lifetime rates of affective disorder and alcohol use disorders are particularly prominent. Finally, binge eating disorder is present in approximately 1 in 10 bariatric surgery candidates.
目前和之前的精神病学在减肥手术候选人中被认为是常见的。然而，准确的患病率估计是困难的，因为减肥手术候选人在接受手术前的精神病评估时，往往希望表现出精神健康。此外，结构化的诊断评估也很少使用。
本报告涉及 199 名参加减肥手术纵向评估研究的患者，他们还参加了减肥手术-3 精神病学子研究。研究地点为 3 所大学医院、1 家私立非营利研究机构和 1 家社区医院。所有患者均独立于常规术前心理社会评估程序进行访谈。患者明确被告知，除非报告自杀等可能导致围手术期不良后果的某些高危行为，否则数据不会与手术团队共享。
大多数患者为女性（82.9%）和白人（非白人 7.6%，西班牙裔 5.0%）。患者的中位年龄为 46.0 岁，中位体重指数为 44.9kg/m2。199 例患者中，33.7%有≥1 种目前的轴 I 障碍，68.8%有≥1 种终身轴 I 障碍。此外，38.7%有重度抑郁症的终身病史，33.2%有酒精滥用或依赖的终身诊断。所有这些比率都远高于全国共病调查-复制研究中该年龄组的人群患病率。此外，13.1%有终身诊断，10.1%有当前的暴食障碍诊断。
减肥手术候选人目前和终身的精神病理学发生率较高，情感障碍和酒精使用障碍的终身发生率尤为突出。最后，大约 10 名减肥手术候选人中就有 1 名患有暴食障碍。
