Osterhues Alexandra, von Lengerke Thomas, Mall Julian W, de Zwaan Martina, Müller Astrid
Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Medical Psychology Unit, Hannover Medical School, Hannover, Germany.
Obes Surg. 2017 Sep;27(9):2378-2387. doi: 10.1007/s11695-017-2629-2.
Past research indicated high psychiatric comorbidity and poor health-related quality of life (HRQOL) in patients seeking surgical treatment for obesity. This study investigated if preoperative bariatric surgery patients perceive equally poor HRQOL and increased levels of anxiety and depression as mentally ill patients.
The study included four groups: 192 bariatric surgery candidates (PRE, 71% women, BMI 48.35 ± 8.98 kg/m), 96 psychotherapy inpatients with mental disorders (PSY, 77% women, BMI 27.12 ± 9.17 kg/m), 103 postoperative bariatric surgery patients (POST, 78% women, BMI 30.38 ± 2.88 kg/m), and a convenience sample of 96 non-clinical volunteers with pre-obesity or obesity grade 1 (CG, 52% women, BMI 29.22 ± 2.64 kg/m). HRQOL was measured using the 12-item short form health survey (SF-12), and psychopathology was assessed with the hospital anxiety and depression scale (HADS).
The PRE group exhibited the lowest physical HRQOL, and the PSY group the lowest mental HRQOL. The highest mental/physical HRQOL was reported by the POST group and the CG, without significant differences between these two groups. While the PSY group scored higher on HADS-anxiety scale than the PRE group, neither group differed with regards to symptoms of depression. The lowest levels of HADS-depression were found in the POST group and the CG.
The present findings suggest that bariatric surgery candidates may suffer from equally high levels of depression as psychotherapy inpatients, but they perceive better mental well-being. Routine mental health evaluation should incorporate assessments for both psychopathology and HRQOL.
DRKS00009901.
既往研究表明，寻求肥胖手术治疗的患者存在较高的精神疾病共病率及较差的健康相关生活质量（HRQOL）。本研究调查了肥胖症手术术前患者是否与精神疾病患者一样，认为自己的HRQOL同样较差，且焦虑和抑郁水平升高。
该研究包括四组：192例肥胖症手术候选者（PRE组，71%为女性，体重指数[BMI]48.35±8.98kg/m²）、96例患有精神障碍的心理治疗住院患者（PSY组，77%为女性，BMI27.12±9.17kg/m²）、103例肥胖症手术后患者（POST组，78%为女性，BMI30.38±2.88kg/m²），以及96例肥胖前期或1级肥胖的非临床志愿者组成的便利样本（CG组，52%为女性，BMI29.22±2.64kg/m²）。使用12项简短健康调查问卷（SF-12）测量HRQOL，并采用医院焦虑抑郁量表（HADS）评估精神病理学情况。
PRE组的身体HRQOL最低，PSY组的心理HRQOL最低。POST组和CG组报告的心理/身体HRQOL最高，两组之间无显著差异。虽然PSY组在HADS焦虑量表上的得分高于PRE组，但两组在抑郁症状方面并无差异。POST组和CG组的HADS抑郁水平最低。
目前的研究结果表明，肥胖症手术候选者可能与心理治疗住院患者一样，存在较高水平抑郁，但他们感觉心理健康状况更好。常规心理健康评估应同时纳入精神病理学和HRQOL评估。
DRKS00009901
