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减肥手术后重度抑郁症、广泛性焦虑症和饮食失调症的严重程度及患病率比较。

The comparison of severity and prevalence of major depressive disorder, general anxiety disorder and eating disorders before and after bariatric surgery.

作者信息

Matini Diana, Ghanbari Jolfaei Atefeh, Pazouki Abdolreza, Pishgahroudsari Mohadeseh, Ehtesham Mehdi

机构信息

1. MD, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.

2. Assistant Professor of Psychiatry, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Med J Islam Repub Iran. 2014 Oct 8;28:109. eCollection 2014.

Abstract

BACKGROUND

Severe obesity is highly co-morbid with psychiatric disorders and may have effect on the quality of life. This study aimed to compare severity and prevalence rate of depression, anxiety and eating disorders and quality of life in severe obese patients before and 6 months after the gastric bypass surgery.

METHODS

This was a prospective observational study which conducted at Hazarat Rasool-Akram Hospital in Tehran, 2012. Questionnaires included demographic questions, eating disorder Inventory (EDI), The Short Form Health Survey (SF-36) for quality of life, Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and Hamilton Rating Scale for Depression (HRSD) and anxiety (HRSA). Participants were interviewed two times, before surgery and six months after, to determine changes of the disorders. Patients with the history of bariatric surgery, individuals younger than 18 year old and those who disagreed to join the study were excluded.

RESULTS

In assessing the eating disorder inventory-3rd version (EDI-3), Significant reduction in drive for thinness (DT) (p= 0.010), bulimia (B) (p< 0.0001) and body dissatisfaction mean (BD) (0.038) was observed at the 6-month follow-up. At this period, the mean for physical component summary of SF36, significantly decreased (p< 0.0001), however mental component summary did not significantly differ (p= 0.368); Also differences in severity of anxiety (p= 0.852), and depression in HRSD (p= 0.311), prevalence of depression (p= 0.189) and prevalence of general anxiety disorder according to SCID (p=0.167) did not differ significantly, at this period.

CONCLUSION

Although weight loss after bariatric surgery improved the physical component of quality of life, this improvement did not affect the mental aspect of life, depression and anxiety and it seems that these psychopathologies need attention and treatment in addition to weight loss treatments in patients with obesity.

摘要

背景

重度肥胖与精神疾病高度共病,可能影响生活质量。本研究旨在比较胃旁路手术前及术后6个月重度肥胖患者的抑郁、焦虑和饮食失调的严重程度、患病率以及生活质量。

方法

这是一项前瞻性观察性研究,于2012年在德黑兰的哈扎拉特·拉苏勒 - 阿克拉姆医院进行。问卷包括人口统计学问题、饮食失调量表(EDI)、生活质量简表健康调查(SF - 36)、DSM - IV轴I障碍结构化临床访谈(SCID - I)以及汉密尔顿抑郁量表(HRSD)和焦虑量表(HRSA)。参与者在手术前和术后6个月接受两次访谈,以确定疾病的变化。排除有减肥手术史、年龄小于18岁以及不同意参与研究的个体。

结果

在评估饮食失调量表第3版(EDI - 3)时,在6个月随访时观察到追求瘦身驱动力(DT)(p = 0.010)、暴食(B)(p < 0.0001)和身体不满均值(BD)(0.038)显著降低。在此期间,SF36身体成分总结均值显著下降(p < 0.0001),然而精神成分总结无显著差异(p = 0.368);同时,焦虑严重程度差异(p = 0.852)、HRSD中抑郁差异(p = 0.311)、抑郁患病率(p = 0.189)以及根据SCID的广泛性焦虑症患病率(p = 0.167)在此期间均无显著差异。

结论

尽管减肥手术后体重减轻改善了生活质量的身体成分,但这种改善并未影响生活的精神方面、抑郁和焦虑,似乎这些精神病理学问题在肥胖患者的减肥治疗之外还需要关注和治疗。

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