Mitchell James E, Steffen Kristine, Engel Scott, King Wendy C, Chen Jia-Yuh, Winters Ken, Sogg Stephanie, Sondag Cindy, Kalarchian Melissa, Elder Katherine
Neuropsychiatric Research Institute and the University of North Dakota School of Medicine, Fargo, North Dakota.
Neuropsychiatric Research Institute and the University of North Dakota School of Medicine, Fargo, North Dakota.
Surg Obes Relat Dis. 2015 Jul-Aug;11(4):897-905. doi: 10.1016/j.soard.2014.10.026. Epub 2014 Nov 13.
Recent literature suggests that some patients may develop addictive disorders after bariatric surgery, in particular after Roux-en-Y gastric bypass (RYGB). These may include traditional addictions and so called "behavioral addictions," although prevalence data on the latter have not been published. The objective of this study was to establish the prevalence of addictive behaviors in adults after RYGB.
Participants from a large observational study of bariatric surgery who had undergone RYGB were recruited to complete additional measures. Of 241 consented participants, 201 provided data (i.e., Structured Clinical Interview for DSM-IV Axis I [SCID], additional Impulsive Control Disorder Modules, and various self-report measures, including the Alcohol Use Disorder Identification Test [AUDIT]) to assess status before surgery and in the first 3 postoperative years.
Based on the SCID, 16 (8.0%) developed alcohol use disorder [AUD] within 3 years post-RYGB, 7 (43.8%) of whom had no history of AUD. When both the SCID and AUDIT were used to identify AUD, the corresponding numbers/percentages were 32 (18.4%) and 13 (40.6%). Data on other behavioral addictive disorders indicated 19 (9.5%) had a postsurgery disorder, 6 (31.6%) of whom had no history.
These data add to a growing literature suggesting there is a substantial risk for the development of AUD after bariatric surgery. Understanding the risk for nondrug-related addictive disorders requires more data from larger studies before clear conclusions can be drawn.
近期文献表明，一些患者在减肥手术后可能会出现成瘾性障碍，尤其是在接受Roux-en-Y胃旁路术（RYGB）后。这些障碍可能包括传统成瘾和所谓的“行为成瘾”，尽管关于后者的患病率数据尚未公布。本研究的目的是确定RYGB术后成人成瘾行为的患病率。
从一项大型减肥手术观察性研究中招募接受过RYGB的参与者，以完成额外的测量。在241名同意参与的参与者中，201人提供了数据（即《精神疾病诊断与统计手册》第四版轴I障碍的结构化临床访谈[SCID]、额外的冲动控制障碍模块以及各种自我报告测量，包括酒精使用障碍识别测试[AUDIT]），以评估手术前和术后前3年的状况。
根据SCID，16人（8.0%）在RYGB术后3年内出现酒精使用障碍[AUD]，其中7人（43.8%）既往无AUD病史。当同时使用SCID和AUDIT来识别AUD时，相应的数字/百分比分别为32人（18.4%）和13人（40.6%）。关于其他行为成瘾性障碍的数据表明，19人（9.5%）术后出现障碍，其中6人（31.6%）既往无相关病史。
这些数据进一步丰富了现有文献，表明减肥手术后发生AUD的风险很大。在得出明确结论之前，了解非药物相关成瘾性障碍的风险需要来自更大规模研究的更多数据。
