Department of Psychosomatic Medicine and Psychotherapy, University Hospital Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
Integrated Research and Treatment Center (IFB) AdiposityDiseases, Leipzig University Medical Center, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany.
Eat Weight Disord. 2020 Aug;25(4):999-1010. doi: 10.1007/s40519-019-00720-w. Epub 2019 Jun 1.
The present study aimed to compare prevalence rates of childhood maltreatment between patients with severe obesity undergoing bariatric surgery and patients without a surgical procedure. Second purpose was to calculate the association between childhood maltreatment and outcomes 6 and 12 months after a bariatric procedure.
Childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ) and compared between 120 bariatric surgery patients and 346 non-surgery patients with severe obesity. For the bariatric surgery subgroup, linear mixed models with repeated measures were used to analyze the predictive value of childhood maltreatment on weight outcomes and psychopathology. Additionally, between- and within-group comparisons were calculated to compare patients with and without childhood maltreatment regarding BMI and weight loss (%TWL, %EWL), depression severity (BDI-II), eating disorder psychopathology (EDE-Q), and suicidal ideation (BSS), at baseline, 6- and 12-month assessment.
Prevalence rates for childhood maltreatment, depression and suicidal ideation were significantly higher in non-surgery compared to bariatric surgery patients. Within the surgery group, no significant interaction effect between childhood maltreatment and time was found. Hence, childhood maltreatment did not impact the course of body weight, depression and eating disorder psychopathology from pre- to post-surgery.
Significantly higher rates of childhood maltreatment were found within non-surgery patients with obesity in comparison to bariatric surgery patients. Childhood maltreatment did not predict poorer outcomes after surgery. Since history of childhood maltreatment may increase the risk for psychological disturbances, regular screening and, if necessary, psychological support should be offered to both groups.
Evidence obtained from well-designed cohort or case-control analytic studies, Level III.
Deutsches Register Klinischer Studien-German Clinical Trials Register: DRKS00003976.
本研究旨在比较行减重手术的严重肥胖患者与未行手术的严重肥胖患者的童年期虐待发生率。其次目的是计算童年期虐待与减重手术后 6 个月和 12 个月结局之间的相关性。
使用童年创伤问卷（CTQ）评估童年期虐待情况，并将 120 名减重手术患者和 346 名严重肥胖非手术患者进行比较。对于减重手术亚组，采用具有重复测量的线性混合模型分析童年期虐待对体重结局和精神病理学的预测价值。此外，计算了有无童年期虐待患者的组间和组内比较，以比较 BMI 和体重减轻（%TWL、%EWL）、抑郁严重程度（BDI-II）、饮食障碍心理病理学（EDE-Q）和自杀意念（BSS）在基线、6 个月和 12 个月评估时的差异。
与减重手术患者相比，非手术患者的童年期虐待、抑郁和自杀意念发生率显著更高。在手术组中，未发现童年期虐待与时间之间存在显著的交互效应。因此，童年期虐待并未影响手术前后的体重、抑郁和饮食障碍心理病理的病程。
与减重手术患者相比，肥胖非手术患者的童年期虐待发生率显著更高。童年期虐待并未预测手术预后不良。由于童年期虐待史可能会增加心理障碍的风险，因此应定期对两组患者进行筛查，如果需要，应提供心理支持。
来源于精心设计的队列或病例对照分析研究的证据，III 级。
德国临床试验注册处：DRKS00003976。
