PSITEC Lab EA 4072, University of Lille, Domaine du Pont de Bois, BP 60149, 59653, Villeneuve d'Ascq Cedex, France.
Nutrition Department, Arras General Hospital, 3, Boulevard Georges Besnier, CS 90006, 62022, Arras, France.
Eat Weight Disord. 2021 Apr;26(3):949-961. doi: 10.1007/s40519-020-00934-3. Epub 2020 May 28.
Bariatric surgery (BS) is considered the most effective treatment for severe obesity. Nevertheless, long-term studies have identified some concerning issues, such as increased postoperative rates of suicide and substance use disorders. Some investigators have postulated that these postoperative issues might result from differences in psychological characteristics between patients with obesity seeking BS and those seeking non-surgical (medical) care. The aim of this study was to explore the psychological differences between patients seeking BS and those seeking non-surgical care.
151 patients seeking BS (BS group) and 95 patients seeking medical care (non-surgery group) completed questionnaires measuring depression, anxiety, self-esteem, body dissatisfaction, hopelessness and weight-loss expectations (WLE).
There were no differences between the BS and non-surgery groups in depression, anxiety or self-esteem. Body dissatisfaction and WLE were greater in the BS group than in the non-surgery group. Contrary to our hypothesis, the non-surgery group showed higher levels of hopelessness than the BS group. Correlation analyses revealed very similar associations between psychological characteristics for both groups. Hierarchical regression and moderation analyses identified self-esteem as the factor most predictive of hopelessness in both groups.
We found few differences in psychological characteristics between groups. The lower level of hopelessness in the BS group might be seen as a form of protection leading up to surgery but may result from the patient's view of BS as their "last best hope". Further studies are needed to understand the evolution of these psychological characteristics after surgery and their possible effects on postoperative outcomes.
Level III, case-control analytic studies.
减重手术（BS）被认为是治疗严重肥胖症最有效的方法。然而，长期研究已经发现了一些令人担忧的问题，例如手术后自杀和物质使用障碍的发生率增加。一些研究人员推测，这些术后问题可能是由于寻求 BS 治疗和寻求非手术（医学）治疗的肥胖症患者之间的心理特征差异所致。本研究旨在探讨寻求 BS 治疗和寻求非手术治疗的患者之间的心理差异。
151 名寻求 BS（BS 组）的患者和 95 名寻求医疗护理（非手术组）的患者完成了评估抑郁、焦虑、自尊、身体不满、绝望和减肥期望（WLE）的问卷。
BS 组和非手术组在抑郁、焦虑或自尊方面没有差异。BS 组的身体不满和 WLE 高于非手术组。与我们的假设相反，非手术组的绝望程度高于 BS 组。相关分析显示，两组之间的心理特征存在非常相似的关联。分层回归和调节分析确定自尊是两组中最能预测绝望的因素。
我们发现两组之间的心理特征差异很小。BS 组较低的绝望程度可能被视为手术前的一种保护形式，但可能是由于患者将 BS 视为他们的“最后一线希望”。需要进一步的研究来了解这些心理特征在手术后的演变及其对术后结果的可能影响。
三级，病例对照分析研究。
