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肥胖症手术治疗后出现的问题性饮酒及相关特征。

Problematic Alcohol Use and Associated Characteristics Following Bariatric Surgery.

机构信息

Neuropsychiatric Research Institute, 120 South 8th St, Fargo, ND, 58103, USA.

Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA.

出版信息

Obes Surg. 2018 May;28(5):1248-1254. doi: 10.1007/s11695-017-3008-8.

Abstract

PURPOSE

Evidence suggests that a significant minority of individuals who undergo Roux-en-Y gastric bypass (RYGB) experience problematic alcohol and substance use following surgery. However, little research has examined characteristics, drinking patterns, and possible risk factors within this population. To provide descriptive information of a sample of adults with self-identified alcohol use problems following bariatric surgery, this study examined (1) alcohol and substance use symptoms using standardized assessments, (2) current and past psychiatric comorbidity, (3) subjective changes in alcohol sensitivity following surgery, and (4) specific patterns of alcohol use prior to and following bariatric surgery.

MATERIALS AND METHODS

Adult participants (N = 26) completed a series of structured diagnostic interviews and self-report assessments (e.g., Alcohol Use Disorders Identification Test [AUDIT], Michigan Alcohol Screening Test [MAST], Drug Abuse Screening Test [DAST]) by telephone 1 to 4 years following a RYGB or sleeve gastrectomy.

RESULTS

All participants met objective criteria for current problematic alcohol use based on AUDIT and MAST cutoff scores, reported increased subjective sensitivity to alcohol following surgery, and evidenced significant current and past psychiatric comorbidities, most notably previous major depression (45.5%). Approximately one third of participants evidenced new-onset Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) alcohol use or dependence following surgery. Preoperative drinking frequencies and quantities were similar to those reported during the period of the heaviest postoperative alcohol use.

CONCLUSIONS

Findings have implications for pre- and postoperative prevention and intervention efforts. Additional research is needed to further elucidate risk factors for problematic alcohol use following bariatric surgery.

摘要

目的

有证据表明,在接受 Roux-en-Y 胃旁路手术(RYGB)的患者中,相当一部分人在手术后出现了问题性饮酒和物质使用。然而,很少有研究在这一人群中检查特征、饮酒模式和可能的风险因素。为了提供接受减肥手术后自我报告有饮酒问题的成年人样本的描述性信息,本研究检查了:(1)使用标准化评估工具评估酒精和物质使用症状;(2)当前和既往精神共病;(3)手术后酒精敏感性的主观变化;(4)减肥手术前后的特定饮酒模式。

材料和方法

成年参与者(N=26)通过电话在 RYGB 或袖状胃切除术 1 至 4 年后完成了一系列结构化诊断访谈和自我报告评估(例如,酒精使用障碍识别测试 [AUDIT]、密歇根酒精筛查测试 [MAST]、药物滥用筛查测试 [DAST])。

结果

所有参与者均根据 AUDIT 和 MAST 截断分数符合当前有问题性饮酒的客观标准,报告手术后对酒精的主观敏感性增加,且存在显著的当前和既往精神共病,最常见的是既往重度抑郁症(45.5%)。大约三分之一的参与者在手术后出现了新的《精神障碍诊断与统计手册》(DSM-IV)酒精使用障碍或依赖。术前饮酒频率和数量与术后最重饮酒期间报告的频率和数量相似。

结论

这些发现对术前和术后的预防和干预工作有影响。需要进一步的研究来进一步阐明减肥手术后出现问题性饮酒的风险因素。

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