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寻求减肥手术患者的痛苦耐受力与心理共病

Distress Tolerance and Psychological Comorbidity in Patients Seeking Bariatric Surgery.

作者信息

Koball Afton M, Himes Susan M, Sim Leslie, Clark Matthew M, Collazo-Clavell Maria L, Mundi Manpreet, Kellogg Todd, Graszer Karen, Grothe Karen B

机构信息

Department of Behavioral Health, Gundersen Health System, 1900 South Avenue, La Crosse, WI, 54601, USA.

Department of Psychiatry and Behavioral Medicine, Lahey Hospital and Medical Center, Burlington, MA, 01805, USA.

出版信息

Obes Surg. 2016 Jul;26(7):1559-64. doi: 10.1007/s11695-015-1926-x.

Abstract

INTRODUCTION/PURPOSE: Distress intolerance is characterized by a low threshold for negative emotional experiences and lack of emotion regulation and has been shown to predict various health outcomes. As such, the primary aim of this study was to determine the association between distress tolerance and psychological variables (eating behaviors, mood, substance use, trauma history), completion of bariatric surgery, and post-bariatric surgery weight loss outcomes and follow up with a provider.

MATERIALS AND METHODS

Two hundred forty-eight patients (75 % female, 89 % Caucasian) underwent a multidisciplinary evaluation for bariatric surgery and were assessed for psychiatric disorders via semi-structured clinical interview and psychometric questionnaires.

RESULTS

Low distress tolerance was associated with symptoms of depression (p ≤ 0.001), anxiety (p ≤ 0.001), disordered eating behaviors (p ≤ 0.001), substance abuse (p ≤ 0.001), a history of being the victim of childhood sexual abuse (p ≤ 0.001), and with high BMI (p < .05). Patients endorsing higher levels of distress tolerance were more likely to undergo bariatric surgery (p < .01). Distress tolerance was not related to 2-year post-surgical weight loss outcomes or follow up with a provider.

CONCLUSION

The ability to tolerate negative affect may be a variable that differentiates which patients undergo bariatric surgery rather than early postoperative outcomes.

摘要

引言/目的:痛苦不耐受的特征是对负面情绪体验的阈值较低且缺乏情绪调节能力,并且已被证明可预测各种健康结果。因此,本研究的主要目的是确定痛苦耐受力与心理变量(饮食行为、情绪、物质使用、创伤史)、减肥手术的完成情况、减肥手术后的体重减轻结果以及与医疗服务提供者的随访之间的关联。

材料与方法

248名患者(75%为女性,89%为白种人)接受了减肥手术的多学科评估,并通过半结构化临床访谈和心理测量问卷对精神障碍进行了评估。

结果

低痛苦耐受力与抑郁症状(p≤0.001)、焦虑(p≤0.001)、饮食行为紊乱(p≤0.001)、药物滥用(p≤0.001)、童年期性虐待受害者史(p≤0.001)以及高体重指数(p<0.05)相关。痛苦耐受力较高的患者更有可能接受减肥手术(p<0.01)。痛苦耐受力与术后2年的体重减轻结果或与医疗服务提供者的随访无关。

结论

耐受负面影响的能力可能是一个区分哪些患者接受减肥手术而非术后早期结果的变量。

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