Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Surg Obes Relat Dis. 2019 Jul;15(7):1080-1088. doi: 10.1016/j.soard.2019.04.012. Epub 2019 Apr 17.
History of childhood trauma is associated with increased risk of mental disorders, eating pathology, and obesity.
To examine associations between childhood trauma and changes in depressive symptoms, eating pathology, and weight after Roux-en-Y Gastric Bypass (RYGB).
Three U.S. academic medical centers.
Adults undergoing bariatric surgery (2007-2011) were enrolled in a cohort study. Participants (96 of 114; 86%) completed the Beck Depression Inventory-1 (BDI-1) to assess depressive symptomology, the interviewer-administered Eating Disorder Examination (EDE) to assess subthreshold eating pathology, weight assessment before and 6 months and annually after RYGB for ≥7 years, and the Childhood Trauma Questionnaire (CTQ) once post-RYGB.
Presurgery, median age was 46 years, and median body mass index was 47 kg/m; 79% were female. Data completeness across 7-year follow-up was 78% to 90%, 66% to 91%, and 93% to 100% for the BDI-1, EDE, and weight, respectively. Using mixed models, presence/severity of childhood emotional abuse, emotional neglect, and physical neglect, but not sexual abuse or physical abuse, were significantly associated (P < .05) with change (i.e., less improvement/worsening) in the BDI-1 and EDE global scores, as were higher total CTQ score and more types of moderate-intensity trauma. All CTQ measures were associated (P < .05) with less improvement or worsening in the EDE eating concern and shape concern scores. CTQ measures were not significantly related to weight loss or regain.
Although childhood trauma did not affect weight outcomes after RYGB, those who experienced childhood trauma had less improvement in depressive symptomology and eating pathology and therefore might benefit from clinical intervention.
儿童期创伤史与精神障碍、进食障碍和肥胖的风险增加有关。
研究罗伊思-恩-耶（RYGB）胃旁路手术后抑郁症状、进食障碍和体重变化与儿童期创伤之间的关系。
美国三个学术医疗中心。
对接受减肥手术的成年人（2007-2011 年）进行了队列研究。参与者（114 人中有 96 人；86%）完成了贝克抑郁量表-1（BDI-1）以评估抑郁症状，由访谈者进行的饮食失调检查（EDE）以评估亚临床进食障碍，RYGB 术前和术后 6 个月及之后每年至少 7 年的体重评估，以及 RYGB 术后一次完成的童年创伤问卷（CTQ）。
术前中位年龄为 46 岁，中位体重指数为 47kg/m；79%为女性。7 年随访的资料完整率为 78%至 90%，BDI-1、EDE 和体重分别为 66%至 91%和 93%至 100%。使用混合模型，童年期情感虐待、情感忽视和身体忽视的存在/严重程度，但不包括性虐待或身体虐待，与 BDI-1 和 EDE 全球评分的变化（即改善较少/恶化）显著相关（P<.05），总 CTQ 评分较高和更多种中度创伤也与变化相关。所有 CTQ 测量均与 EDE 饮食关注和体型关注评分的改善较少或恶化相关（P<.05）。CTQ 测量与体重减轻或反弹无显著相关性。
虽然 RYGB 后儿童期创伤并未影响体重结局，但经历过儿童期创伤的人在抑郁症状和进食障碍方面的改善较少，因此可能受益于临床干预。
