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寻求手术治疗和非手术超重治疗的肥胖患者的精神病理学异同。

Psychopathological similarities and differences between obese patients seeking surgical and non-surgical overweight treatments.

作者信息

Castellini Giovanni, Godini Lucia, Amedei Silvia Gorini, Galli Valentina, Alpigiano Giovanna, Mugnaini Elena, Veltri Marco, Rellini Alessandra H, Rotella Carlo Maria, Faravelli Carlo, Lucchese Marcello, Ricca Valdo

机构信息

Psychiatric Unit, Department of Neuropsychiatric Sciences, Florence University School of Medicine, Largo Brambilla 3, 50134, Florence, Italy.

出版信息

Eat Weight Disord. 2014 Mar;19(1):95-102. doi: 10.1007/s40519-013-0058-3. Epub 2013 Sep 8.

Abstract

PURPOSE

To compare the psychopathological characteristics of obese patients seeking bariatric surgery with those seeking a medical approach.

METHODS

A total of 394 consecutive outpatients seeking bariatric surgery were compared with 683 outpatients seeking a medical treatment. All patients were referred to the same institution.

RESULTS

Obesity surgery patients reported higher body mass index (BMI), objective/subjective binging and more severe general psychopathology, while obesity medical patients showed more eating and body shape concerns. Depression was associated with higher BMI among obesity surgery clinic patients, whereas eating-specific psychopathology was associated with higher BMI and objective binge-eating frequency among obesity medical clinic patients.

CONCLUSIONS

Patients seeking bariatric surgery showed different psychopathological features compared with those seeking a non-surgical approach. This suggests the importance for clinicians to consider that patients could seek bariatric surgery on the basis of the severity of the psychological distress associated with their morbid obesity, rather than criteria only based on clinical indication.

摘要

目的

比较寻求减肥手术的肥胖患者与寻求药物治疗的肥胖患者的心理病理特征。

方法

将394例连续寻求减肥手术的门诊患者与683例寻求药物治疗的门诊患者进行比较。所有患者均被转诊至同一机构。

结果

肥胖手术患者报告的体重指数(BMI)更高,存在客观/主观暴饮暴食且总体心理病理状况更严重,而肥胖药物治疗患者表现出更多的饮食和体型问题。在肥胖手术门诊患者中,抑郁与较高的BMI相关,而在肥胖药物门诊患者中,特定饮食心理病理与较高的BMI和客观暴饮暴食频率相关。

结论

与寻求非手术治疗方法的患者相比,寻求减肥手术的患者表现出不同的心理病理特征。这表明临床医生必须考虑到,患者可能是基于与病态肥胖相关的心理困扰的严重程度而寻求减肥手术,而非仅基于临床指征的标准。

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