West Virginia University, Davis College of Agriculture, Natural Resources and Design, Division of Animal and Nutritional Sciences, Department of Human Nutrition and Food, Morgantown, WV, USA.
Department of Behavioral Medicine and Psychiatry, West Virginia University, School of Medicine, Morgantown, WV, USA.
J Obes. 2020 Feb 10;2020:1743687. doi: 10.1155/2020/1743687. eCollection 2020.
The relationship between presurgical psychopathology and weight loss following bariatric surgery is complex; previous research has yielded mixed results. The current study investigates the relationship among presurgical mental health diagnoses, symptom severity, and weight loss outcomes in an Appalachian population, where obesity-related comorbidities are prominent.
A retrospective chart review was performed on bariatric surgery patients in an accredited Appalachian centered academic hospital in northern West Virginia between 2013 and 2015 ( = 347). Data extraction included basic demographics, anthropometrics (percent excess weight loss (%EWL)) at six-month, one-year, and two-year postoperative visits, and two validated psychological questionnaires (Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI)) from patient's presurgical psychological evaluation.
Average patient population was 92.5% Caucasian, 81.5% female, 45 ± 11.5 years old, and 84.1% who underwent laparoscopic Roux-en-Y gastric bypass surgery with the remaining having laparoscopic sleeve gastrectomy. At baseline, no differences were detected in weight, excess body weight, or body mass index between surgery types. Average baseline BDI-II score was 10.1 ± 8.68 (range 0-41) and BAI score was 6.1 ± 6.7 (range 0-36), and this was not significantly different by surgery at baseline. Both baseline psychological scores were in the "minimal" severity range. BDI-II was positively related to BMI of patients at baseline ( = 0.01). Both BDI-II and BAI were not significantly related to %EWL across follow-up.
Other than baseline weight, BDI-II and BAI scores were not related to %EWL outcomes in patients receiving bariatric surgery in the Appalachian region. Future work should examine mixed methods approaches to capture prospective and longitudinal data to more thoroughly delve into mental health aspects of our Appalachian patients and improve efforts to recapture postoperative patients who may have been lost to follow-up.
术前精神病理学与减重手术后的体重减轻之间的关系很复杂；以前的研究结果喜忧参半。本研究调查了阿巴拉契亚地区肥胖相关合并症突出的人群中术前心理健康诊断、症状严重程度和减重手术结果之间的关系。
对 2013 年至 2015 年间位于西弗吉尼亚州北部一家认证的以阿巴拉契亚为中心的学术医院接受减重手术的患者进行了回顾性图表审查（n=347）。数据提取包括基本人口统计学信息、六个月、一年和两年术后访视时的体重指数（%EWL），以及患者术前心理评估中使用的两个经过验证的心理问卷（贝克抑郁量表第二版（BDI-II）和贝克焦虑量表（BAI））。
平均患者人群为 92.5%白种人，81.5%女性，45±11.5 岁，84.1%接受腹腔镜 Roux-en-Y 胃旁路手术，其余接受腹腔镜袖状胃切除术。基线时，两种手术类型之间的体重、超重体重或体重指数无差异。平均基线 BDI-II 评分为 10.1±8.68（范围 0-41），BAI 评分为 6.1±6.7（范围 0-36），且基线时两种手术类型间评分无显著差异。两种基线心理评分均处于“轻度”严重程度范围。BDI-II 与患者基线时的 BMI 呈正相关（r=0.01）。BDI-II 和 BAI 在整个随访期间均与%EWL 无显著相关性。
除基线体重外，BDI-II 和 BAI 评分与阿巴拉契亚地区接受减重手术患者的%EWL 结果无关。未来的工作应该采用混合方法来获取前瞻性和纵向数据，更深入地研究我们的阿巴拉契亚患者的心理健康方面，并努力重新联系可能已经失去随访的术后患者。
