Cohen Megan J, Curran Jennifer L, Phan Thao-Ly T, Reichard Kirk, Datto George A
Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware; Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania.
Department of Developmental Pediatrics, Eastern Maine Medical Center, Bangor, Maine.
Surg Obes Relat Dis. 2017 Jan;13(1):58-64. doi: 10.1016/j.soard.2016.08.020. Epub 2016 Aug 18.
Noncompletion of preoperative bariatric programs is a significant problem among adolescents. Adult studies suggest that psychological factors contribute to noncompletion of preoperative bariatric programs.
The aim of this study was to determine the association between adolescent psychological functioning and completion of the preoperative phase of a bariatric program.
The study was conducted at a tertiary care children's hospital affiliated with a university medical center.
Seventy-four adolescents and their parents completed an assessment measure of psychological functioning with the Behavior Assessment System for Children, Second Edition. We compared these scores between adolescents who completed the preoperative phase of the bariatric program and proceeded to surgery (completers) to those who did not (noncompleters) using multivariate analysis of covariance and logistic regression analyses, adjusting for demographic characteristics and baseline body mass index.
The mean age was 16.0 (1.1) years, most were female (79.8%), and the group was diverse (48.6%, Caucasian; 33.8%, black; 17.6%, other, including Hispanic, Asian, and biracial). Average body mass index was 50.5 (7.6) kg/m. Forty-two percent of participants were noncompleters. Noncompleters were reported by parents to have more clinically significant externalizing and internalizing behaviors and fewer adaptive behaviors. Noncompleters self-reported more clinically significant internalizing symptoms, emotional problems, and poor personal adjustment.
Adolescents who did not complete the preoperative phase of a bariatric surgery program had more clinically significant psychological symptoms across multiple domains compared with those who successfully proceeded to bariatric surgery. Early identification and treatment of psychological symptoms may be important in helping adolescents successfully proceed to surgery.
青少年术前减肥计划未完成是一个重大问题。成人研究表明，心理因素导致术前减肥计划未完成。
本研究的目的是确定青少年心理功能与减肥计划术前阶段完成情况之间的关联。
该研究在一所大学医学中心附属的三级儿童专科医院进行。
74名青少年及其父母使用儿童行为评估系统第二版完成了心理功能评估测量。我们使用协方差多元分析和逻辑回归分析，比较了完成减肥计划术前阶段并进行手术的青少年（完成者）与未完成者（未完成者）之间的这些分数，并对人口统计学特征和基线体重指数进行了调整。
平均年龄为16.0（1.1）岁，大多数为女性（79.8%），群体多样化（48.6%为白人；33.8%为黑人；17.6%为其他，包括西班牙裔、亚裔和混血儿）。平均体重指数为50.5（7.6）kg/m²。42%的参与者为未完成者。父母报告未完成者有更多具有临床意义的外化和内化行为，而适应性行为较少。未完成者自我报告有更多具有临床意义的内化症状、情绪问题和较差的个人适应能力。
与成功进行减肥手术的青少年相比，未完成减肥手术术前阶段的青少年在多个领域有更多具有临床意义的心理症状。早期识别和治疗心理症状可能对帮助青少年成功进行手术很重要。
