Marek Ryan J, Ben-Porath Yossef S, Dulmen Manfred H M van, Ashton Kathleen, Heinberg Leslie J
Department of Psychological Sciences, Kent State University, Kent, OH.
Department of Psychological Sciences, Kent State University, Kent, OH.
Surg Obes Relat Dis. 2017 Mar;13(3):514-521. doi: 10.1016/j.soard.2016.11.008. Epub 2016 Nov 11.
Psychosocial factors contribute to poorer weight loss outcomes following bariatric surgery; however, findings on associations between preoperative psychiatric diagnoses, psychological testing, and weight loss are inconsistent.
Examine associations between presurgical psychiatric diagnoses derived from a semi-structured clinical interview and test scores from the Minnesota Multiphasic Personality-Inventory-2 - Restructured Form (MMPI-2-RF) and 5-year Body Mass Index (BMI) outcomes.
Cleveland Clinic Bariatric and Metabolic Institute METHODS: 446 consecutively consented patients who underwent a Roux-en-Y gastric bypass (RYGB) at least 5 years prior were included in the study. A majority were women (74.2%) and Caucasian (66.2%). Patients' mean presurgical BMI was 49.14 kg/m [SD = 9.50 kg/m]. Psychiatric diagnoses were obtained from a presurgical, semi-structured clinical interview and all participants were administered the MMPI-2-RF at their presurgical evaluations. BMIs were collected at 4 postoperative time points across a 5-year trajectory. This prospective design utilized latent growth curve modeling.
Older patients evidenced a slower rate of BMI reduction over time. A presurgical diagnosis of Binge Eating Disorder predicted higher BMIs at the 5-year outcome. Scores on MMPI-2-RF measures of emotional and behavioral dysfunction domains incrementally predicted poorer weight loss outcomes.
Preoperative indicators of psychopathology, notably indicators that are dimensional in nature, are important in predicting postoperative outcomes. Closer follow-up with patients who evidence presurgical psychological factors, both before and after surgery, may help improve outcomes.
心理社会因素导致减肥手术后体重减轻效果较差；然而，关于术前精神疾病诊断、心理测试与体重减轻之间关联的研究结果并不一致。
研究通过半结构化临床访谈得出的术前精神疾病诊断与明尼苏达多相人格调查表第二版修订版（MMPI-2-RF）测试分数及5年体重指数（BMI）结果之间的关联。
克利夫兰诊所减肥与代谢研究所
本研究纳入了446例至少在5年前接受了Roux-en-Y胃旁路术（RYGB）且连续同意参与的患者。大多数为女性（74.2%）和白种人（66.2%）。患者术前平均BMI为49.14kg/m²[标准差=9.50kg/m²]。通过术前半结构化临床访谈获得精神疾病诊断，所有参与者在术前评估时均接受MMPI-2-RF测试。在5年的时间跨度内，于4个术后时间点收集BMI数据。这种前瞻性设计采用了潜在增长曲线模型。
随着时间推移，年龄较大的患者BMI降低速度较慢。术前暴饮暴食症诊断预示着5年随访时BMI较高。MMPI-2-RF情绪和行为功能障碍领域的测试分数逐步预示着体重减轻效果较差。
术前精神病理学指标，尤其是具有维度性质的指标，对于预测术后结果很重要。对术前有心理因素迹象的患者在手术前后进行更密切的随访，可能有助于改善结果。
