Shen Shu-Chen, Lin Hung-Yen, Huang Chih-Kun, Yen Yung-Chieh
Department of Psychiatry, Bariatric and Metabolic International (BMI) Surgery Center, E-Da Hospital, Kaohsiung, Taiwan.
Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan.
Obes Surg. 2016 Apr;26(4):810-5. doi: 10.1007/s11695-015-1821-5.
The objective of this study was to investigate the effects of adherence to postoperative recommended psychiatric follow-up on weight loss in morbid obesity patients with psychiatric disorders 1 year after gastric bypass.
Three hundred eighteen morbidly obese patients were retrospectively reviewed. They were divided into four groups according to preoperative psychiatric evaluations and adherence to psychiatric follow-up 1 year after their bypass surgery. The first group included patients who did not meet the referral criteria (NMRC). The second group consisted of patients who did not meet the psychiatric diagnostic criteria (NMDC). The third group was patients who met criteria for a psychiatric disorder and were nonadherent (NA) to psychiatric follow-up. The fourth group consisted of patients who met criteria for a psychiatric disorder and were adherent (A) to psychiatric follow-up.
The A group exhibited higher % change in BMI than the NA and NMRC groups at 1 year after bypass surgery. Regression analyses to examine the effects of the grouping variable on % change in BMI were performed by controlling the effects of age, gender, educational level, and preoperative BMI. The regression coefficient for the grouping variable was 0.175 (p = .003) at the 6-month and 0.133 (p = .027) at the 1-year % change in BMI.
Our preliminary data suggest that adherence to postoperative psychiatric follow-up is associated with greater postoperative weight loss. However, evidence from studies with a longer follow-up is required to justify this therapeutic approach.
本研究的目的是调查病态肥胖且患有精神疾病的患者在胃旁路手术后1年,坚持术后推荐的精神科随访对体重减轻的影响。
对318例病态肥胖患者进行回顾性分析。根据术前精神科评估以及旁路手术后1年对精神科随访的依从性,将他们分为四组。第一组包括不符合转诊标准(NMRC)的患者。第二组由不符合精神科诊断标准(NMDC)的患者组成。第三组是符合精神疾病标准但未坚持(NA)精神科随访的患者。第四组由符合精神疾病标准且坚持(A)精神科随访的患者组成。
在旁路手术后1年,A组的BMI变化百分比高于NA组和NMRC组。通过控制年龄、性别、教育水平和术前BMI的影响,进行回归分析以检验分组变量对BMI变化百分比的影响。在BMI变化百分比的6个月时,分组变量的回归系数为0.175(p = 0.003),在1年时为0.133(p = 0.027)。
我们的初步数据表明,坚持术后精神科随访与术后体重减轻更多相关。然而,需要来自更长随访期研究的证据来证明这种治疗方法的合理性。