Department and Institute of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo, SP, Brazil.
Department of Surgery, University of São Paulo Medical School, São Paulo, SP, Brazil.
Psychiatry Res. 2017 Nov;257:1-6. doi: 10.1016/j.psychres.2017.07.020. Epub 2017 Jul 10.
The current study investigates the patterns of disease persistence and comorbidity of psychiatric disorders among patients with class III obesity in pre-operative period. For 393 treatment-seeking patients with severe obesity recruited from a bariatric center, we ascertained their psychiatric diagnosis through Structured Clinical Interview for DSM-IV (SCID-I). Following, the frequency, persistence and comorbidity pattern of psychiatric disorders in this sample were determined. Current psychiatric disorders were observed in over half of patients during preoperative period, being anxiety disorders the most frequent diagnosis. For lifetime disorders, mood disorders were the most frequent diagnosis. Most of the sample presented 2 or more concurrent lifetime psychiatric disorders. While mood and eating disorders were frequent conditions, anxiety disorders were the most persistent conditions (the highest one month-to-lifetime prevalence ratio) and were significantly correlated with bipolar, depressive and eating disorders. Psychiatric disorders are frequent and enduring conditions among patients looking for bariatric surgery. Comorbid anxiety, mood, and eating disorders are remarkable features in treatment-seeking patients with obesity. Prognostic implications of preoperative psychiatric disorders on surgery outcome should be demonstrated prospectively in intervention studies.
本研究调查了术前 III 类肥胖患者精神障碍的持续模式和共病情况。对来自减重中心的 393 名寻求治疗的严重肥胖患者进行了研究，我们通过 DSM-IV 定式临床访谈 (SCID-I) 确定了他们的精神科诊断。随后，确定了该样本中精神障碍的频率、持续性和共病模式。在术前期间，超过一半的患者存在当前的精神障碍，焦虑障碍是最常见的诊断。对于终身障碍，情绪障碍是最常见的诊断。大多数患者同时存在 2 种或更多的终身精神障碍。虽然情绪和饮食障碍是常见的情况，但焦虑障碍是最持久的情况（最高的 1 个月到终身患病率比），并且与双相情感障碍、抑郁和饮食障碍显著相关。精神障碍在寻求减重手术的患者中很常见，且持续存在。共病焦虑、情绪和饮食障碍是肥胖患者寻求治疗的显著特征。术前精神障碍对手术结果的预后意义应在干预研究中前瞻性地证明。
